Tox

Question 1

Nalaxone dose

Answer 1

2.0 (may need x4 q 1-2 min for fentanyl)

Question 2

vent rate, volume in acidotic patients

Answer 2

10cc/kg, 20/min

Question 3

Tx Hypotension not responsive to NS

Answer 3

2-20mcg/min Epi

Question 4

If QRS >100ms after Na Blocking drugs >

Answer 4

IV bicarb

Question 5

torsades tx

Answer 5

MgSO$ 2gm over 2 min > 1gm/hr drip

Question 6

Seizure tx

Answer 6

lorazepam 0.1mg/kg (repeat only once, 7minutes)
propofol+intubation if refractory
pyridoxine 5mg for INH/Gyrometria

Question 7

Urine alkalinization indications and pH goals

Answer 7

Phenobarb, Methanol, Salicylates

Urine pH >7.5, serum

Question 8

Dialysis goof for

Answer 8

Methanol
Ethylene Glycol
Theophylline
Aminita
Lithium
Salicylates

Question 9

Cholinergic tox tx

Answer 9

Atropine 2mg, double dose until secretions stop > drip 10% of total loading dose / hour
Add pralidoxime 1gm

Question 10

Sympathomimetics tx

Answer 10

IV lorazepam 2mg repeat PRN,

IVF for rapdo proph

Question 11

tx salicylates tox

Answer 11

2amps bicarb > 3 amps bicarb in IL D5W

infuse at 1.5-2x maintence

Question 12

TCA ecg

Answer 12

terminal R in aVR, wide QRS

Question 13

TCA OD tx

Answer 13

if V tach > bicarb, hypervent, Lidocain 1.5mg/kg > 20-50mcg/min, MgSO4 2g in 2 minutes (same for torsades)
If Siezures > lorazepam 0.1mg./kg, bicarb, prpoful
if moribound > IV fat emulsion and echmo

Question 14

Beta blocker OD tx

Answer 14

Atropine 0.5 mg q 3-5min up to 3mg
IVF, IV bicarb for QRS widening
Glucaon 5mg q10x2
IV Ca Gluconnate 2-4amps
NE or epi 2-20mcg/min
insulin and glucose
lipid emulsion

Question 15

Digoxin ECG

Answer 15

scooped T wave depressions
a tach with block, PVCs, VT with bigeminy, accel jxnl rhythm
(along with halos, confusion, weakness)

Question 16

Dig tox tx

Answer 16

activated charcoal
atropine 0.5mg q3-5 up to 3
digibind acute 10vials, chronic 3 vials

Question 17

Tylenol OD

Answer 17

Gi decontamination, 4 hr apap level

Question 18

Tylenol OD 4 hours- 24tx

Answer 18

APAP, LFTs, Coags

Firsst dose NAC if apap not available within 8 hours of ingestion

Question 19

Tylenol OD unknown time frametx

Answer 19

GI decontamination, LFT, coags, NAC

If LFTS increase or APAP > 10 continue NAC

Question 20

Tylenol known toxic dose tx

Answer 20

decontamination, LFTs, APAP

NAC