Principles of managing poisoned patients Flashcards
What drugs cause miosis, mydriasis? What causes conjunctival haemmorhage?
Miosis- opiates Mydriasis-anticholinergics, sympathomimetics Vomiting and trauma
When can charcoal be given and what poisons is it not recommended for?
Within 1 hour of overdose Not for alcohol, glycols, acids/alkalis, iron and lithium
Overdose with which types of drugs give symptoms similar to sepsis?
Salicylates
What is the best intervention in salicylate poisoning?
Urine alkalisation through IV NaCO3to achieve urine pH of 7.5-8.5. This significantly increases the rate of salicylate excretion
What is the cure for opiates?
Naloxone
What is the cure for benzodiazepines?
Flumazenil
What is the cure for paracetamol poisoning?
Acetylcysteine
What is rhabdomyolysis? What sign indicates rhabdomyolysis and why?
Hypoxic muscle damage. Release of muscle cell contents- creatine kinase, myoglobin and potassium. Myoglobin precipitates in the kidney and causes coa-cola urine.
What are the signs of salicylate poisoning?
Nausea, vomiting, tinnitus, deafness, sweating, hyperventilation, metabolic acidosis
What are the signs of TCA overdose?
Coma, hypertonia, mydriasis, tachycardia
What are the signs of methanol and quinine poisoning?
Blindness
How soon does a gastric lavage have to be given to be potentially beneficial?
1 hour
What is the process of whole bowel irrigation? Who is it usually used for?
2L/H orally. Body packers
What is MDAC? What is it benefical in?
Enhances elimination of absorbed drug by ‘gastrointestinal dialysis’ • Totally distinct to single dose AC for reducing absorption • Evidence of benefit in patients poisoned with carbamazepine, quinine, theophylline and dapsone
What are chelating agents used for?
Heavy metal poisoning
What is flumazenil used for?
GABA antagonist for benzo poisoning
