Overdose and poisoning Flashcards
toxidrome
constellation of signs/symptoms that suggest a particular class of poison
Cholinergic Toxidrome
SLUDGE and the killer B’s
Salivation Lacrimation Urination Defication Gastro upset Emesis Bradycardia, Bronchorrhea, Bronchospasm
Also mioisis and lethargy
Organophosphates, carbamates, mushrooms
anti-cholinergic toxidrome
hyperthermia dry mouth urinary retention confusion mydriasis flushed skin tachycardia
Serotonin syndrome symptoms
Confusion, flushing, diaphoresis, tremor, myoclonic jerks, hyperthermia, hypertonicity, rhabdomyolysis
sympathomimetic toxidrome
hypertension mydriasis grinding teeth seizures tachycardia rhabdomyolysis
opiate overdose toxidrome (3)
miosis
reduced consciousness
bradypnoea
Causes of raised anion gap metabolic acidosis (mudpiles cat)
methanol uraemia DKA paraldehyde iron lactic acidosis ethylene glycol salicylate carbon monoxide aminoglycosides theophylline
Causes of normal anion gap metabolic acidosis (hands ups)
hyperventilation acids renal tubular acidosis diarrhoea ureterosigmoidoscopy pancreatic fistulas saline
3 broad principles of poisoning management
reducing absorption
increasing elimination
antidote administration
ways to reduce poison absorption (4)
kin decontamination
activated charcoal
gastric lavage
whole bowel irrigation
ways to increase poison elimination
haemodialysis
haemoperfusion
urinary alkalisation
When is activated charcoal most effective?
when given within 2 hours of ingestion and substance ingested known to be absorbed by charcoal
known carbamazepine or phenytoin ingestion - what can be done?
Multiple doses of charcaol
when is it acceptable to try multiple doses of charcoal?
known carbamazepine or phenytoin ingestion
Paracetamol toxic level?
more than 75mg/kg
Digoxin effect
Reverse check
