Poisoning Flashcards
Drug used to counteract an opioid overdose?
Naloxone
How does naloxone counteract the effects of the opioid overdose?
Competitively binds to opioid receptors blocking opioids from doing so
Is Paracetamol metabolised by the kidneys or the liver?
Liver
How does Paracetamol work?
We don’t really know
Clinical features of a Paracetamol overdose?
Nausea / vomiting
Hepatic failure:
- jaundice
- RUQ pain
- encephalopathy
- hypoglycaemia
Renal failure:
- oliguria
- metabolic acidosis
Investigations of a Paracetamol overdose?
Paracetamol levels in blood only if over than 4 hours after ingestions
LFTs Glucose U+E Prothrombin time ABG: look for metabolic acidosis
Management of Paracetamol overdose?
If less than 8 hours after ingestion give activated charcoal
Acetylcysteine; promotes conjugation of circulating Paracetamol
Which drug contains salicylic acid?
Aspirin
An 86 year old man is brought to A+E after he got confused taking his daily aspirin and took 3 more pills than he should have done.
What clinical features would you expect him to have?
Tinnitus
Lethargy
Dizziness
Nausea / vomiting
A 23 year old man who has been recently diagnosed with HIV, is brought into A+E after taking a whole pack of aspirin.
What clinical features would you expect to see?
Dehydration Sweating Bounding pulse Deafness Breathless Confusion, disorientation
Pulmonary oedema
Metabolic acidosis
A 23 year old man who has been recently diagnosed with HIV, is brought into A+E after taking a whole pack of aspirin.
How would you investigate this patient?
Measure blood salicylate concentration to ensure it is this that has poisoned him
Renal function, U+E
Glucose
K: likely to be low
Urine pH and ABG
An 86 year old man is brought to A+E after he got confused taking his daily aspirin and took 3 more pills than he should have done.
How would you manage this patient?
A less severe overdose so give activated charcoal
Rehydration
Supportive care
A 23 year old man who has been recently diagnosed with HIV, is brought into A+E after taking a whole pack of aspirin.
How would you manage this patient?
Gastric lavage
Aggressive rehydration
Give glucose
Give sodium bicarbonate
Unfortunately the 23 year old man who had taken the aspirin overdose takes a turn for the worse.
He goes into renal failure and begins fitting.
How should you manage him now?
Haemodialysis
How does CO cause damage to the body?
It binds to haemoglobin, reducing the carrying capacity of oxygen in the blood
So the body and brain are starved of oxygen
Causes death
