Pharmacology Flashcards
Antidote for lorazepam (benzodiazepines)
Flumazenil
OD vodka (methanol)
Ethanol
OD Digoxin
Digoxin Specific antibodies
OD Paracetamol
- activated charcoal if ingested < 1 hour ago
- N-acetylcysteine (NAC)
- liver transplantation
OD Salicylate
- urinary alkalinization with IV bicarbonate
- haemodialysis
OD Tricyclic antidepressants
- IV bicarbonate may reduce the risk of seizures and arrhythmias in severe toxicity
- arrhythmias: class 1a (e.g. Quinidine) and class Ic antiarrhythmics (e.g. Flecainide) are contraindicated as they prolong depolarisation.
- Class III drugs such as amiodarone should also be avoided as they prolong the QT interval.
- Response to lignocaine is variable and it should be emphasized that correction of acidosis is the first line in management of tricyclic induced arrhythmias
OD lithium
- mild-moderate toxicity may respond to volume resuscitation with normal saline
- haemodialysis may be needed in severe toxicity
- sodium bicarbonate is sometimes used but there is limited evidence to support this. By increasing the alkalinity of the urine it promotes lithium excretion
Heparin antidote
protamine sulphate
Beta-blockers antidote
- if bradycardic then atropine
- in resistant cases glucagon
Ethylene glycol(antifreeze)
- fomepizole
- ethanol
- haemodialysis
Methanol poisoning
- fomepizole or ethanol
- haemodialysis
Organophosphate insecticides intoxication
atropine
pralidoxime still unclear
OD Iron
desferrioxamine
Lead, arsenic, gold and mercury intoxication
dimercaprol
calcium edetate (lead)
CO intoxication
- 100% oxygen
- hyperbaric oxygen
Cyanide poisoning
- Hydroxocobalamin;
- also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate
Gynaecomastia
- spironolactone (most common drug cause)
- cimetidine
- digoxin
- cannabis
- finasteride
- GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids
cocaine
- cocaine blocks the uptake of dopamine, noradrenaline and serotonin
Treat: benzodiazepines,
- if myocardial infarction develops then primary percutaneous coronary intervention
- hypertension: benzodiazepines + sodium nitroprusside
- cardiovascular
coronary artery spasm → myocardial ischaemia/infarction
both tachycardia and bradycardia may occur
hypertension
QRS widening and QT prolongation
aortic dissection - neurological
seizures
mydriasis
hypertonia
hyperreflexia - psychiatric effects
agitation
psychosis
hallucinations - others
ischaemic colitis + rectal bleeding
hyperthermia
metabolic acidosis
rhabdomyolysis
Mirtazapine
- antidepressant - blocking alpha2-adrenergic receptors
older people
- sedation and an increased appetite,
Macrolides side dffects
Motility issues
Arrhythmia
Cholestatic hepatitis
Rash
eOsinophilia
Organophosphate poisoning
atropine is the antidote
inhibiting acetylcholinesterase
Salivation
Lacrimation
Urination
Defecation/diarrhoea
cardiovascular: hypotension, bradycardia
also: small pupils, muscle fasciculation
