Poisoning

Question 1

Give 3 neurological signs of poisoning and what may produce these signs

Answer 1

• UMN signs (TCA, anti emesis, antihistamines, antiparkinsons, antipsychotics)
• Coma (many)
• Dystonic movements (metoclopramide (anti N+V))

Question 2

Name 3 pupil signs and describe what’d cause them

Answer 2

Dilated= TCAs, amphetamines
Blindness + dilated= quinine, ethanol
Constricted pupil= opiates, nerve agents

Question 3

Give one drug which can cause hypoventilation and one which can cause hyperventilation

Answer 3

Hyper= salicylates (aspirin)
Hypo= opiates, carbon monoxide also

Question 4

Name one recreational drug which can cause hyponaturaemia

Answer 4

Ecstasy

Question 5

Name one ECG change caused by digoxin

Answer 5

Depressed T waves (inverted tick) + other hypokalaemia change

Question 6

What drug OD may present like an MI

Answer 6

cocaine

Question 7

Give 2 management options if a poisoning/ OD presents in the 1st hr

Answer 7

• activated charcoal

- gastric levage (rare)

Question 8

Give antidotes for opiates and benzodiazepam

Answer 8

opaites= naloxone 
Benzodiazepam= flumezanil

Question 9

Give one antidote for B blocker OD

Answer 9

Atropine

Question 10

Give an antidote for digoxin

Answer 10

Digibind

Question 11

Describe the treatment of paracetamol OD

Answer 11

• Check need for intervention of paracetamol treatment line

- Give N- acetyl cysteine which will replace glutathione and so NAPQI can be broken down