Poisoning/overdose Flashcards
Lead poisoning
signs/presentation
Abdominal pain, constipation, neuropsychiatric features, basophilic stippling, blue lines on gum margin
Magnesium sulphate
Respiratory rate and reflexes
Give calcium gluconate
Tricyclic antidepressant poisoning
IV bicarbonate
Theophylline OD
management
Theophylline levels!
Activated charcoal
Levothyroxine OD
Activated charcoal if:
- within 1 hour of ingestion
- >10mg was ingested
- cooperative
If symptomatic: propranolol
If asymptomatic: discharge
Antifreeze = ethylene glycol
Treatment
MoA
- Fomepizole
- Ethanol (competes with ethylene glycol for alcohol dehydrogenase)
- HD
Lead poisoning
tests
raised serum delta aminolaevulinic acid (similar to porphyria)
raised urinary coproporphyrin
Lead poisoning chelating agents
dimercaptosuccinic acid (DMSA)
D-penicillamine
EDTA
dimercaprol
Lithium toxicity management
IV bicarbonate
If neurological signs: HD
visual field defects, hearing loss and paraesthesia
fish/whale
mercury poisoning
Paracetamol overdose
What to give
Indications for treatment
<1 hour = activated charcoal
Acetylcysteine given if:
- plasma conc above treatment line
- staggered overdose
- 8-24 hours after ingestion of 150+mg/kg
- >24 hours w jaundice/hepatic tenderness
Paracetamol overdose
Indications for liver transplant
pH <7.3 after ingestion
PT >100 seconds
creatinine >300
Grade III or IV encephalopathy
Reversal of beta blocker
IV glucagon
Cyanide toxicity mechanism
Inhibits the mitochondrial enzyme cytochrome c oxidase
Serotonin syndrome
Symptoms
Fever
Increased muscle tone
Hyperreflexia
Clonus
