Poisons etc Flashcards
What are three ways to reduce absorption of toxins?
- induce emesis with ipecac
- gastric lavage
**activated charcoal
What is the emetic agen in ipecac?
-cephaeline
What are the contraindications for induced emesis with ipecac?
- age < 9mo
- Hydrocarbon or corrosive ingestion
- Risk of CNS depression or seizures
- No gag reflex = aspiration risk
- Pregnancy
What are the indications for ipecac?
- ingestion within 1 hour of presentation
- asymptomatic
What are the indications for gastric lavage?
- ingestion within 4 hours
* best within 1hr
What are the contraindications for gastric lavage?
- acid or alkali ingestion
- severe bleeding diathesis
What are the complications of gastric lavage?
- aspiration pneumonitis
- esophageal perforation
- CV instability
What are the complications of ipecac?
- Aspiration pneumonitis
- Mallory-Weiss tear of the esophagus
- Protracted vomiting
What is the recommendation for activated charcoal use?
-use alone in the alert, relatively asymptomatic aduclt, with a mild to moderate poisoning
What are the 4 non-specific therapies to enhance elimination of a toxin?
- multiple doses of charcoal
- alkaline diuresis
- hemodialysis
- hemoperfusion
What is the antidote for acetaminophen poisoning?
N-acetylcysteine (mucomist)
What is the antidote for carbon monoxide poisoning?
-oxygen
What is the antidote for B-blocker overdose?
-glucagon
What is the antidote for cyanide?
Nitrates
What is the antidote for digoxin overdose?
-digoxin-specific Fab fragments
