poisoning Flashcards
when does the liver damage peak following paracetamol OD?
1-2 days post ingestion
what is the physiology of toxicity in paracetamol OD?
overwhelming of glutathione.
xs oxiadation products cause necrosis of liver cells.
paracetamol OD - how is liver damage monitored?
INR
Markers of poor prognosis in paracetamol OD..
INR >3 or
high CK orH
pH <7.3
- at more than 24h post OD
How does NAC work in paracetamol OD?
it binds the hepatotoxic metabolites (meaning they cannot cause necrosis)
what are the presenting signs of TCA OD?
anticholinergic:
puppilary dilation, confusion, tachycardia, hypotension.
signs of TCA OD on ECG
long QT
wide QRS
how is TCA OD treated?
Bicarbonate IV
diazepam for seizures
what are the common signs of carboxyhaemoglobin /CO toxicity?
agitation
confusion
arrhythmias
fever
pink mucosae
vomiting
hypertonia / hyper-reflexia
how is CO toxicity treated?
100% oxygen via mask
hyperbaric chamber
what is the sequele of treated CO poisoning?
neuropsychiatric changes to brain function
iron overdose.. what is the cause and how is it treated?
accidental ingestion
(mulitvitamins) is most common
Desferrioxamine (chelating agent)
explain salicylate overdose pathophysiology
stimulation of CNS -> respiratory alkalosis
accumulation of organic acids -> metablioc acidosis
what are the early features of salicylate OD?
low potassium
tachypnoea (r. alkalosis)
sweating
tinnitus
what are the late features of salicylate OD?
hypoglycaemia
long APTTr
pulmonary oedema
metabolic acidosis
