Overdoses

Question 1

Lithium Toxicity

• Precipitants
• Symptoms
• Management

Answer 1

Precipitants:
Dehydration, renal failure, drugs: diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs and metronidazole.

Symptoms:
Coarse tremor, hyperreflexia, acute confusion, polyuria, seizure, coma

Management:
IV saline, haemodialysis if severe

Question 2

Digoxin toxicity

• Precipitants
• Symptoms
• Management

Answer 2

Precipitants:
Hypokalemia, increasing age, renal failure, myocardial ischaemia
hypomagnesaemia, hypercalcaemia, hypernatraemia, acidosis, hypoalbuminaemia, hypothermia, hypothyroidism, other drugs partciularly cardiac or fluid related

Symptoms:
Generally unwell, lethargy, nausea & vomiting, anorexia, confusion,** yellow-green vision**, arrhythmias, gynaecomastia

Management:
Digibind