Overdose and poisoning Flashcards
what are the general treatment principles for poisoning?
- gastric emptying
- activated charcoal
- whole bowel irrigation
how many hours does it take to run out of glutathione in paracetomal posinong?
8
why is NAPQI toxic?
Binds to hepatocellular proteins causing oxidative damage and mitochondrial damage
what is the paracetomal dose doe high risk of serious toxicity?
150mg/kg
what is the paracetomal dose for causing ocassional toxicity?
75-150mg/kg
what dose of paracetamol will lead to liver failure?
12g
what are the symptoms for paracetomal poisoning?
2-3 days: features due to hepatic necrosis. subcostal pain, tenderness, nausea, vomiting, jaundice, renal failure
what are the early benefits of NAC for paracetomal poisoning?
- restores glutathione to conjugate with NAPQI
what are the late benefits of NAC for paracetomal poisoning?
- antioxidant effects
when is NAC most beneficial?
When given within 8 hours
how long do you wait until testing LFT levels after paracetamol poisoning?
Four hours
what do you do if a patient with paracetamol poisoning presents before 4h?
- wait till 4 hours and measure levels
- start NAC ttreatment
- check results and determine whether to continue NAC treatment
what do you do if a patient presents with paracetamol poisoning after 15hours?
Measure levels
Check Pt, U and E, LFT, check results
Continue treatment
who are high risk patients for paracetamol poisoning?
- chronic alcohol misuse
- eating disorders
- enzyme inducing drugs
- cystic fibrosis
what do you do if someone has an allergic reaction to NAC?
- Stop infusion for 30 mins then restart
- give chlorphreniramine and hydrocortisone
