Overdose management Flashcards

1
Q

What is the antidote to paracetamol?

A

N-acetylcysteine

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2
Q

What is the antidote to aspirin?

A

sodium bicarbonate

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3
Q

What is the antidote to opiates?

and what is the dosage

A

naloxone

400mcg titrations up to 4mg

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4
Q

What is the antidote to tricyclic antidepressants?

A

sodium bicarbonate

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5
Q

What is the antidote to b-blockers?

A

glucagon

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6
Q

what is the reversal agent for warfarin?

A

vitamin K

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7
Q

What is the antidote to benzodiazepines?

A

flumenizil (but never give if recreational overdose)

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8
Q

what is the reversal agent to LMWH?

A

protamine sulphate

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9
Q

what is the reversal agent to unfractionated heparin?

A

protamine sulphate

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10
Q

what is the reversal agent to rivaroxaban?

A

recombinant factor 10a

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11
Q

what is the reversal agent to dabigatran?

A

idarucizumab

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12
Q

what is the time limit for use of activated charcoal in paracetamol overdose?

A

1hr

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13
Q

when should paracetamol antidote be used?

A

staggered overdose, high plasma paracetamol concentrations

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14
Q

At what rate should acetylcysteine be infused?

A

over 1hr to reduce adverse effects

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15
Q

what is an adverse effect of acetylcysteine? and what is the management of this?

A
anaphylactoid reactions (non-IgE mast cell release)
stop infusion and start again at a slower rate
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16
Q

what are the King’s college hospital criteria for liver transplant following paracetamol overdose?

A
  1. arterial pH <7.3 24hrs post ingestion

2. All three of: prothrombin time >100, creatinine >300, grade III or IV encephalopathy

17
Q

What toxidrome does the following presentation represent?

Increased HR +BP, hot, dry, dilated pupils, no bowel sounds

A

Anticholinergic overdose (atropine, antihistamines)

18
Q

What toxidrome does the following presentation represent?

Constricted pupils, profusely sweating

A

cholinergic overdose (organophosphates, pilocarpine, mushrooms)

19
Q

What toxidrome does the following presentation represent?

Decreased HR + BP, decreased resp rates, cold, dry, pinpoint pupils

A

opioid overdose

20
Q

What toxidrome does the following presentation represent?

Increased heart rate, increased resps, hot, dilated pupils, sweating

A

sympathomimetics (caffeine, cocaine, amphetamine, LSD, MDMA)

21
Q

What toxidrome does the following presentation represent?

decreased HR + BP, decreased resps, cold, no pupillary change, dry

A

sedative (muscle relaxants, anti-epileptics, benzos)

22
Q

what is the antidote to organophosphate overdose?

A

atropine

23
Q

what is the antidote to anticholinergic overdose?

A

sodium bicarb

24
Q

ACS caused by cocaine management

A

normal + IV benzos