Poisoning

Question 1

Within what time frame should gastric decontamination methods be used?

Answer 1

1 hr

Question 2

What methods of gastric decontamination are available?

Answer 2

Activated Charcoal
Gastric Aspiration/Lavage
Induced emesis is no loner used

Question 3

What amount of activated charcoal should be used in overdose?

Answer 3

10x dose of poison taken (up to 50g)

Question 4

When should N-acetylcysteine be given following paracetamol overdose?

Answer 4

Nomogram - check if level requires n-acetylcysteine treatment
Highly effective up to 8 hours, some benefit shown up to 24 hours
Current opinion supports use at any time after severe poisoning

Question 5

What is a common adverse effect of N-acetylcysteine and how common is it?

Answer 5

ANAPHYLACTOID REACTION - up to 15% of patients
get urticaria, wheeze and hypotension
not a true allergic reaction caused by dose related histamine release
you should reduce the infusion rate and give anti-histamines

Question 6

What three types of effects does tri-cyclic posioning have on the body?

Answer 6

Anticholinergic
Sodium channel blocking
Alpha blocking

Question 7

What are the adverse effects of desferrioxamine?

Answer 7

Red discolouration of urine

Hypotension and pulmonary oedema

Question 8

What should be given to prevent CNS penetration in aspirin overdose and protect the heart in tri-cyclic overdose?

Answer 8

Sodium Bicarbonate