The principles of managing a poisoned patient

Question 1

What do miopic pupils indicate?

Answer 1

Constricted pupils indicate opioid overdose

Question 2

What do mydriatic pupils indicate?

Answer 2

Dilated pupils indicate sympathomimetic overdose. If they are fixed and dilated it may indicate temporary brainstem impairment from TCA overdose.

Question 3

What can jaundice of the sclera indicate?

Answer 3

Paracetamol overdose

Question 4

Which drug overdose shows broad complex tachycardia?

Answer 4

TCA overdose

Question 5

What is creatine kinase levels looked at for?

Answer 5

Can give an early indicator of rhabdomyolysis before kidney damage occurs

Question 6

What are the four main steps in the management of poisoning?

Answer 6

Symptomatic and supportive measures
Reducing absorption
Enhancing elimination
Specific antibiotics

Question 7

What are the three ways that absorption can be decreased?

Answer 7

Using gastric lavage, rarely used
Activated charcoal, absorbs drug to its surface
Whole bowel irrigation is often used in drug smuggling patients

Question 8

What is flumazenil used for?

Answer 8

Benzodiazepine overdose