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Week 104 - Suicide/Self harm > Poisoning > Flashcards

Poisoning Flashcards

1
Q

Which gender is poisoning most common in?

A

Females

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2
Q

What is the commonest age group of poisoning?

A

15 - 24 y/o

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3
Q

What percentage of poisonings are clinically serious?

A

5%

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4
Q

Which groups of patients are most successful at suicide as a result of poisoning most?

A

Older patients

Young males

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5
Q

Which drugs are the most common method of poisoning?

A

Paracetamol

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6
Q

Which drugs are increasingly causing death from poisoning?

A

Opiates
Analgesics
Psychotropic drugs

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7
Q

What is most commonly used in the poisoning of children?

A

Household products

Most deaths are from Carbon monoxide

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8
Q

What steps may be needed for managing poisoning?

A 
Resuscitation
Supportive care
Decontamination
Identification
Antidotes
Enhance elimination
Management of complications
Psychosocial support

Most cases: simple resuscitation and supportive care

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9
Q

When would intubation be considered in resuscitation?

A

If unable to breath for themselves or if loss of gag reflex

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10
Q

What things should be excluded if a patient has arrhythmias?

A

Exclude:

  • hypoxia
  • acidosis
  • electrolyte imbalance
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11
Q

What drugs should be given to control convulsions?

A

IV lorazepam

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12
Q

What are the methods of decontamination?

A

Reduced absorption

  • forced emesis
  • gastric lavage
  • activated charcoal (within 1 hour of ingestion)
  • catharsis
  • whole bowel irrigation

Enhances elimination

  • urine alkalinisation
  • forced diuresis
  • renal dialysis
  • haemoperfusion
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13
Q

What drugs could present with the following clinical symptoms?

  • coma
  • hypertonia
  • myoclonus
  • mydriasis
  • sinus tachycardia
A

TCAs

Antihistamines

Orphenadrine

Thioridazine

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14
Q

What drugs could present with the following clinical symptoms?

  • coma
  • miosis
  • reduced RR
A

Opiates

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15
Q

What drugs could present with the following clinical symptoms?

  • N&V
  • Tinnitus
  • Deafness
  • Sweating
  • Hyperventilation
  • Vasodilation
  • Metabolic acidosis
A

Salicylates

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16
Q

What drugs could present with the following clinical symptoms?

  • coma
  • hypotonia and hyporeflexia
  • hypotension
  • plantar response: extensor or absent
A

Benzodiazepines +/- alcohol

Barbiturates

Severe TCAs

17
Q

What drugs could present with the following clinical symptoms?

  • hyperthermia
  • tachycardia
  • delirium
  • agitation
  • mydriasis
A

MDMA

18
Q

What is the antidote of paracetamol?

A

N-acetyl cysteine

Methinonine (alternative)

19
Q

What is the antidote of benzodiazepines?

A

Flumazenil

20
Q

What is the antidote of opiates?

A

Naloxone

21
Q

What is the antidote of beta-blockers?

A

Glucagon

22
Q

What is the antidote of iron?

A

Desferrioxamine

23
Q

What is the antidote of paraquat?

A

Fullers earth

24
Q

What is the antidote of methanol?

A

Ethanol

25
Q

What is the antidote of digoxin?

A

Digoxin-specific antibodies

26
Q

What are some of the symptoms of TCA poisoning?

A 
Drowsiness
Dry mouth
Mydriasis
Tachycardia
Hyperreflexia
Extensor plantars
Ataxia
Confusion
Fits and coma
Metabolic acidosis
Respiratory failure
Myocardial depression
Arrythmias
27
Q

Which patients are high risk following paracetamol poisoning?

A

Patients on enxyme inducing drugs

Alcoholics

HIV patients

Anorexia nervosa patients/malnutrition patients

28
Q

What are the features of paracetamol toxicity?

A

Anorexia, N&V after 24 hours

Abdo pain

Hyper/hypoglycaemia

Metabolic acidosis

Jaundice / encepalopathy

Renal failure

29
Q

What are the clinical symptoms of Carbon monoxide poisoning?

A

Headache

N&V

Vertigo

Subjective weakness

Altered level of consciousness

30
Q

What are the physical signs of carbon monoxide poisoning?

A

Skin: cherry red lips and nail beds - uncommon

CVS: sinus tachycardia

CNS: Signs can be very varied resembling a CVA, drug overdose, or loss ofconsciousness
Also cortical blindness, aphasia, Parkinsonian or manic depressive states

31
Q

What is the treatment for Carbon monoxide poisoning?

A

Remove patients from CO containing atmosphere

100% oxygen until asymptomatic and COHb < 10%

Week 104 - Suicide/Self harm (1 decks)

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