Overdose Flashcards
Presentation of aspirin overdose
Tinnitus, nausea and vomiting, fever, confusion
Signs of aspirin overdose
Tachycardia, fever, initial respiratory alkalosis then later by metabolic acidosis
Diagnosis of aspirin overdose
VBG looking for acid base imbalance and salicyclate levels
Management of aspirin overdose
IV fluids, sodium bicarbonate, potassium chloride.
Dialysis
Aim of management in aspirin overdose
Maintain good kidney function and to alkalise thhe urine to increase salicyclate excretion
Complications of aspirin overdose
Renal function decline, chest XR showing pulmonary oedema, CT head if signs of cerebral oedema
Symptoms of digoxin poisoning
Dizziness, nausea and vomiting, palpitations, visual haloes, yellow/green colour disturbance, confusion
Signs of digoxin poisoning
Bradycardia typically without hypotension, Hyperkalaemia
What is the active component in anti-freeze
Ethylene glycol
Early features of ethylene glycol poisoning
Apparent intoxication, nausea and vomiting, haematemesis, seizures, ataxia, opthalmoplegia, papilloedema, pulmonary oedema, raised anion gap metabolic acidosis
Later features of ethylene glycol poisoning
Acute tubular necrosis, hypocalcaemia, hyperkalaemia, hypomagnesaemia
Management of ethylene glycol if acute presentation
Gastric lavage or NG aspiration if <1 hour since ingestion
Management of ethylene glycol overdose
Fomepizole which prevents metabolism. Alcohol if unavailable, haemofilatration in severe cases
Management of digoxin overdose
Immediate digoxin level, IV fluids, correct electrolyte abnormality, continuous cardiac monitoring
When is digibind given in digoxin poisoning
If levels >15 after 6 hours
If levels >10 within 6 hours
If symptomatic
Symptoms of paracetemol overdose
None, nausea and vomiting, loin pain, abdominal pain, coma
Signs of paracetemol overdose
Haematuria, proteinuria, jaundice, severe metabolic acidosis
Management of paracetemol overdose
N-acetylcysteine (NAC)
What is a complication of NAC treatment
Can cause analphylactoid reaction which are not true reactions,but managed by stopping the infusion temporarily and restarting at lower rate
Which groups of patients is there an increased risk of toxicity from paracetemol in
Long term enzyme inducers, regular alcohol excess, pre-existing liver disease, glutathione-deplete states - eating disorders, malnutrition, HIV
Signs of TCA overdose
Drowsiness, arrhythmias, seizures, vomiting, headache, flushing, dilated pupils, confusion
Investigations into TCA overdose
FBC and VBG (acidosis)
ECG showing QT prolongation
Management of TCA overdose
Supportive, ITU, RRT
Features of benzodiazepine toxicity
Lethargy, ataxia, slurred speech, coma, respiratory depression
