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Y5 ED > Poisoning > Flashcards

Poisoning Flashcards

1
Q

What is the management in paracetamol poisoning ?

A

Activated charcoal if ingested under 1 hour ago
N-acetylcysteine
(Liver transplant)

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2
Q

What is the management in salicylate poisoning ?

A

IV bicarbonate
Haemodialysis

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3
Q

What is the management in opioid overdoses ?

A

Naloxone

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4
Q

What is the management in benzodiazepine overdose

A

Supportive care
Flumazenil if severe or iatrogenic due to risk of seizures

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5
Q

What is the management in tricyclic depressant overdose ?

A

IV bicarbonate

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6
Q

What is the management in lithium overdose ?

A

Mild - moderate may respond to normal saline resus
Haemodialysis if severe

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7
Q

What is the management in warfarin overdose ?

A

Vitamin K
Prothrombin complex

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8
Q

What is the management in heparin overdose ?

A

Protamine sulphate

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9
Q

What is the management in methanol poisoning ?

A

Ethanol or fomepizole
Haemodialysis

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10
Q

What is the management in CO poisoning ?

A

100% o2
Hyperbaric oxygen

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11
Q

What is the management in cyanide poisoning ?

A

Hydroxocobalamin with amyl nitrite, sodium nitrite and sodium thiosulphate

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12
Q

How does CO poisoning occur ?

A

CO has a high affinity for Hb and myoglobin resulting in a left shift of the oxygen dissociation curve and tissue hypoxia.
Hb will then have a reduced oxygen carrying capacity.

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13
Q

What are some features of CO toxicity ?

A

Headache
N&V
Vertigo
Confusion
Subjective weakness

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14
Q

What are some severe features of CO toxicity ?

A

Pink skin and mucosae
Hyper pyrexia
Arrhythmias
Extra-pyramidal features
Coma
Death

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15
Q

Why may O2 sats be falsely high in CO poisoning ?

A

The pulse oximetry cant detect the differences between oxyhaemoglobin and carboxyHb.

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16
Q

What investigations should be performed in CO poisoning ?

A

VBG
ABG
ECG

17
Q

What is the typical carboxyHb level in a non-smoker ?

A

Less than 3%

18
Q

What is the typical carboxyHb level in a smoker ?

A

Less than 10%

19
Q

At what level of carboxyHb does CO poisoning become symptomatic ?

A

Over 10 % ( headache and vomiting )

20
Q

In CO poisoning what level of carboxyHb indicates severe toxicity ?

A

Over 30%

21
Q

What are some signs and symptoms of methanol poisoning ?

A

Nausea
Intoxication
Ataxia
Blindness

22
Q

What groups are at an increased risk of paracetamol overdose ?

A

Patients taking liver enzyme inducing drugs - rifampicin, phenytoin, carbamazepine
Malnourished patients

23
Q

What are some early features of tricyclic depressant overdose ?

A

Dry mouth
Dilated pupils
Agitation
Sinus tachycardia
Blurred vision

24
Q

What are some features indicating severe tricyclic overdose ?

A

Arrhythmias
Seizures
Metabolic acidosis
Coma

Y5 ED (5 decks)

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