Obj. 9 - drug overdoses & poisonings Flashcards
Give activated charcoal for ethanol overdose.
T/F
False.
Alcohol is absorbed too quickly for activated charcoal to be effective.
Patients unconscious due to ethanol get ____ to prevent Wernicke’s encephalopathy.
thiamine
What will be the acid-base status of a patient with salicylate overdose?
anion gap metabolic acidosis
What 4 things will you do/give for salicylate overdose?
- activated charcoal
- gastric lavage
- sodium bicarb
- glucose
What 2 things can be given for acetaminophen overdose, and what is the timeline for these?
Within 1-2 hours of ingestion: activated charcoal
Within 8-10 hours of ingestion: N-acetylcysteine (antidote)
What 2 things are you NOT going to do in a case of alkali poisoning?
DON’T induce vomiting (reinjures esophagus)
DON’T give neutralizing agents (exothermic rxn = burns)
What will you give immediately for acid ingestion?
8 oz water, to dilute
What are the effects of organophosphates?
cholinergic, basically: DUMBBELS ~defecation ~urination ~miosis ~bronchospasm ~bradycardia ~emesis ~lacrimation ~salivation
There are 2 main reasons you may not want to induce emesis in some overdoses/poisonings. What are the reasons and what are some example substances?
- avoid reinjuring the esophagus (e.g. alkali)
2. to avoid aspiration due to depressed CNS (benzos, organphosphates)
What 2 drugs will you administer in a case of organophosphate poisoning?
- atropine to dry bronchial secretions
2. pralidoxime
What are the effects of tricyclic antidepressant overdose?
4
- anticholinergic effects (mydriasis, dry mouth)
- QRS widening (ventricular arrhythmias)
- seizures
- hyperthermia
What can be given for elevated serum iron after an iron overdose?
deferoxamine
Which drug OD will have hypoglycemia appear on the workup?
Ethanol
What is more accurate for ethanol OD, serum or breath levels?
serum
Why is someone with an ASA OD hyperpneic?
because they’re in metabolic acidosis and they’re compensating by increasing respirations
What is the major cause of death from PCP OD?
HYPERTENSIVE CRISIS
How does PCP OD lead to liver failure?
Rhabdomyolysis
When are the symptoms usually present for acetaminophen toxicity?
24-48 hours after ingestion (also when hepatic aminotransferase labs start to rise too)
What can alkali ingestion cause?
liquefactive necrosis
What is considered the “narcan of the benzos”?
Flumazenil
In which OD do we hear decreased bowel sounds/gastroparesis?
Opiates
What EKG findings are characteristic for Methadone OD?
QT prolongation and torsades
What kind of poisoning should you suspect if I say: Miosis + Sweating + Hyperperistalsis?
Organophosphate
Do you give beta-blockers to Amphetamine OD to lower their BP?
NO, absolutely not! Can lead to paradoxical hypertension
