Poisoining

Question 1

Which drugs are activated charcoal especially effective in? (5)

Answer 1

1. Carbamazepine
2. Dapsone
3. Phenobarbital
4. Quinine
5. Theophylline

Question 2

S&S: Alcohol

Answer 2

Movement, brain

e.g. ataxia and nystagmus

Question 3

S&S: Aspirin

Answer 3

Deafness & Tinnitus

Question 4

Treatment Options: Aspirin (3)

Answer 4

1. Activated charcoal
2. Sodium bicarbonate
3. Dialysis

Question 5

S&S: Opioids

Answer 5

Respiratory depression & Pinpoint pupils

Question 6

Treatment: Opioids

Answer 6

Naloxone

Question 7

S&S: Paracetamol

Answer 7

Initially: Just nausea and vomiting
Later: Encephalopathy, haemorrhaging, cerebral oedema

Question 8

Treatment: Paracetamol

Answer 8

IV Acetylcysteine - 3 consecutive infusions

Question 9

S&S: TCAs

Answer 9

Dry mouth

Question 10

Treatment: TCAs (3)

Answer 10

1. Charcoal
2. Sodium bicarbonate
3. IV Lorazapam

Question 11

S&S: SSRIs

Answer 11

Tremor, nystagmus, sinus tachycardia

Serotonin syndrome:

• Confusion, agitation, restlessness
• Sweating, HYPERthermia, HYPERtension

Question 12

Treatment: SSRIs (2)

Answer 12

1. Charcoal

2. IV lorazapam

Question 13

S&S: Antipsychotics

Answer 13

• Movement disorders (can be at therapeutic doses)

- Arrhythmias, Convulsions, ECG

Question 14

Treatment: Antipsychotics (2)

Answer 14

1. Charcoal

2. Procyclidine for EPSEs

Question 15

S&S: BDZ

Answer 15

Drowsiness, Movement disorders & Respiratory depression

Question 16

Treatment: BDZ

Answer 16

Charcoal & Flumazenil (specialist)

Question 17

S&S: Beta blockers

Answer 17

Bradycardia, Lightheadedness & Hypotension, Hypoglycaemia

Question 18

Treatment: Beta Blockers

Answer 18

1. Atropine

2. IV Glucagon

Question 19

S&S: Calcium channel blockers

Answer 19

Hypotension, Heart Block, Arrythmias

Question 20

Treatment: Calcium channel blockers (4)

Answer 20

1. Charcoal
2. Calcium chloride / Calcium gluconate
3. Atropine
4. Insulin and glucose

Question 21

S&S: Iron Salts

Answer 21

Abdominal pain, vomiting blood & rectal bleeding

Question 22

Treatment: Iron Salts

Answer 22

Desferrioxamine mesilate

Question 23

Causes: Lithium (4) - Reduced excretion

Answer 23

1. Dehydration
2. Renal function deterioration
3. Infections
4. Co-administration with NSAIDs/Diuretics

Question 24

S&S: Lithium

Answer 24

Weakness, Muscle tremor, Electrolyte imbalance, Dehydration, Hypotension

Question 25

Treatment: Lithium (3)

Answer 25

1. Haemodialysis
2. Fluids
3. Gastric lavage

Question 26

S&S: Cocaine, ecstasy, amfetamines

Answer 26

Wakefulness, Paranoia & Hallucinations

Question 27

Managment: Cocaine, ecstasy, amfetamines

Answer 27

Diazepam

For ecstasy - methylenedioxymethamfetamine

Question 28

S&S: Theophylline

Answer 28

Fast and sick

Question 29

Management: Theophylline (5)

Answer 29

1. Repeated doses of charcoal (MR)
2. Ondansetron for vomiting
3. IV potassium chloride
4. IV lorazapam
5. Short acting beat blocker

Question 30

Management: Digoxin

Answer 30

Digifab

Question 31

Management: Dabigatran

Answer 31

Idarucizumab

Question 32

Management: Warfarin

Answer 32

Vitamin K (PHYTOMENADIONE)