Poisoning and Overdoses

Question 1

Finding that suggests Ethylene glycol as overdose agent

Answer 1

Calcium oxalate crystals

Question 2

Drug given to inhibit alcohol metabolism in methanol overdose

Answer 2

Fomepizole

Question 3

Osmolar gap level indicating methanol poisoning and need for dialysis

Answer 3

> 25

Question 4

Drug class that will cause hyperglycemia in addition to bradycardia if OD’d

Answer 4

Calcium channel blockers

Question 5

Antidote to beta blocker overdose

Answer 5

glucagon

Question 6

Antidote to calcium channel blocker overdose

Answer 6

calcium chloride

Question 7

Antidote to beta blocker or calcium channel blocker overdoses IF first line antidote fails

Answer 7

High dose insulin

Question 8

Insulin regimen in patients with severe beta blocker or calcium channel blocker overdose

Answer 8

1 unit/kg bolus then 1 unit/kg/h drip

add glucose as needed

Question 9

Antidotes for cyanide toxicity

Answer 9

Hydroxycobalamin or sodium nitirite or sodium thiosulfate

Question 10

Treatment for antidepressant overdose

Answer 10

Charcoal if early
Alkanalization of blood
Sodium loading
Supportive

Question 11

Drug class to avoid in serotonin syndrome from SSRI overdose

Answer 11

Antipsychotics

Question 12

Should you give serotonin antagonists in SSRI overdoses?

Answer 12

No

Question 13

Antidote to sulfonylurea overdoses

Answer 13

Octreotide

Question 14

3 meds for cholinergic medications (organophosphates)

Answer 14

Atropine for secretions
Glycopyrrolate for secretions (especially if atropine supply limited)
Pralidoxime for weakness

Question 15

Drug that lowers seizure threshold in methamphetamine overdose

Answer 15

Haloperidol

Question 16

Basic treatment for methamphetamine overdose

Answer 16

High doses of benzo’s for agitation
IV fluids for rhabdo from agitation

Question 17

Antidote to benzodiazepines

Answer 17

Flumazenil

Question 18

Why not to give flumazenil to benzodiazepine overdoses in chronic use

Answer 18

Seizures are common and that makes benzo’s for seizure control ineffective

Question 19

Antidote to opioid overdose

Answer 19

Naloxone (Narcan)

Question 20

Poisoning associated with waterpipe (Hookah) smoking

Answer 20

Carbon monoxide

Question 21

2 toxic alcohol ingestions that cause an osmolar gap AND an anion gap

Answer 21

Methanol and ethylene glycol

Question 22

2 toxic alcohol ingestions that cause an osmolar gap WITHOUT an anion gap

Answer 22

Ethanol and isopropanol