Poisons

Question 1

What is used to treat paracetamol toxicity

Answer 1

Acetylcysteine

Question 2

What is used to treat cyclophosphamide toxicity

Answer 2

MENSA

Question 3

What treatment can be given to try and prevent absorption of toxic chemicals by the stomach

Answer 3

Use gastric lavage to remove the chemical - stomach pump

Activated charcoal - requires large amount. Helps remove toxic agents

Question 4

What methods can be used to help increase the elimination of a toxic drug

Answer 4

Continued activated charcoal for benzodiazepines and phenobarbital

Sodium bicarbonate for salicylate poisoning

Haemodialysis for drugs with short t1/2

Question 5

Name some antidotes

Answer 5

Competitive antagonists - naloxone (opioids) , atropine (nerve agents and pesticide)

Chelating agents - sodium nitrate and sodium thiosulfate for cyanide poisoning

Manipulating drug metabolism - fomepizole, acetylcysteine

Antibodies - antivenom, digoxin-specific antibody

Question 6

Which pateints should be targeted for medication optimisation

Answer 6

Polypharmacy

Complex medication regimens

Recently discharged

Frequent admission to hospital

Comorbidities

Medication prescribed from multiple sources

High risk medication

Long term use of psychotropic drugs

Question 7

Name some CYP450 inducers

Answer 7

Rifampicin

Carbemazepine

Phenytoin

St John’s Wort

Chronic alcohol

Barbiturates

Sulphonylureas - gliclazide

Question 8

Name some CYP450 inhibitors

Answer 8

Ciprofloxacin

Antifungals

Fluoxetine

Paroxetine

HIV antivirals

Erythromycin

Omeprazole

Disulfiram

Sodium valporate

Isoniazid