Posioning Flashcards
(34 cards)
hyperventilation, tinnitus, deafness, vasodilatation, sweating - which drug OD?
Aspirin
Treatment for aspirin overdose?
Sodium bicarbonate, haemodialysis
Drug OD that may require dialysis?
Salicylates, lithium
Monitoring in aspirin overdose?
Monitor plasma-salicylate level, pH, electrolytes
Coma, respiratory depression, pinpoint pupils - which OD?
Opioid
Sx of paracetamol OD
Sx: N&V, RUQ pain (hepatic necrosis, worst 3-4d after overdose)
drowsiness, ataxia, dysarthria, nystagmus (occasionally respiratory depression and coma) - which drug OD?
Benzodiazepine
Treatment for benzo OD?
Flumazenil
Initial treatment for TIA
Tx: aspirin 300mg for 2w
Management for ischaemic stroke
Dx: CT then MRI with diffusion
Tx:
≤4.5h and no contraindication to thrombolysis: thrombolysis (alteplase) then aspirin 300mg for 2w
>4.5h or contraindication to thrombolysis: aspirin 300mg for 2w
Secondary prevention: clopidogrel 75mg for life
Doses in status epilepticus
Buccal midazolam 10mg
IV lorazepam 0.1mg/kg
Community tx of meningitis?
Benzylpenicillin or cefotaxime (give IM before urgent transfer to hospital then IV)
Sx overlap with subarachnoid haemorrhage
Verbal response component of GCS?
- Oriented
- Confused
- Words
- Sounds
- None
Motor response of GCS?
- Obeys commands
- Localises
- Withdraws
- Abnormal flexion (decorticate)
- Abnormal extension (decerebrate)
- None
cardiac arrest management
CPR 30:2 (attach defibrillator)
Assess rhythm
Shockable (VF or pulseless VT) - 1 shock
Non-shockable (PEA or asystole) - no shock
CPR 30:2 for 2m
Assess rhythm…
Adrenaline 1mg of 1:10,000 IV (repeat every 3-5m)
Amiodarone 300mg IV (after 3 shocks)
Reversible causes of cardiac arrest:
‘The H’s’ - hypoxia, hypovolaemia, hypo-/hyper-kalaemia, hypothermia
‘The T’s’ - thrombosis, tension pneumothorax, tamponade, toxins
1, V5, V6 leads - which ACS?
Left circumflex artery
Lateral MI
V1-V4 leads?
anterior MI (anterior/septal)
LAD
II, III, avF - which MI and which artery is affected?
Inferior MI
Right coronary artery (RCA)
Seconary prevention - ‘BADS’
ACS
BB - bisoprolol 2.5mg PO
ACEi - ramipril 1.25mg PO
Dual antiplatelets - aspirin 75mg and clopidogrel 75mg PO
Statin - atorvastatin 80mg PO
Acute treatment of ACS?
“MONAC”
Morphine 10mg IV and metoclopramide 10mg IV
O2 if hypoxic (<94%)
Nitrates
Aspirin 300mg PO
Clopidogrel 300mg PO
Treatment of NSTEMI
GRACE score
Low risk - nil
High risk - consider glycoprotein IIb/IIIa (eptifibatide or tirofiban) and coronary angiography
Fondaparinux or UH
Narrow complex tachycardia?
1 vagal manouvres
#2 adenosine 6mg IV (12mg, 12mg)
Broad complex tachycardia?
Regular
Amiodarone 300mg IV over 10-20 mins (then 900 mg over 24 hours)
Irregular (torsades de pointes)
Magnesium sulphate 2g IV
Treatment of bradycardia?
1 atropine 500mcg IV (repeat to max 3 mg)
#2 transcutaneous pacing