Things to revise

Question 1

How do you manage an overdose?

Answer 1

Advanced life support involves administration of a fat emulsion such as ‘Intralipid’ because LA is fat soluble

Question 2

How do you manage methemoglobinemia?

Answer 2

Methylene blue injection which reduces MeHb back to OxyHb

Question 3

How overdose work?

Answer 3

· Sodium channels are found on all excitable cell membranes: Neural (peripheral and central nervous) tissue and muscle cells
· In overdose, CNS effects occur before CVS effects
· The LA can bind to the heart and cause relaxation
· There is an initial excitatory response then depression
· Unexpected overdoses can occur due to things heart and haptic failure

Question 4

Name the three types of antidepressants

Answer 4

• Tri-cyclic antidepressants
• Selective-serotonin reuptake inhibitors
• Mono-amine oxidase inhibitors (MAOIs):

Question 5

How do you manage hyperthyroidism?

Answer 5

Avoid vasoconstrictors, or at least minimised to one to two cartridges for the poorly controlled hyperthyroid patient

Question 6

What is pheochromocytoma? How do you manage it?

Answer 6

It is a tumour of the adrenal medulla which causes excessive secretion of adrenaline = hypertension

Management:

• Do NOT use a vasoconstrictor
• Do not treat until it is medically corrected