Tox intro, Tylenol OD Flashcards
1
Q
Coma cocktail for comatose Pts
A
Dextrose (D50 IV): hypoglycemia Thiamine: known alcoholic Narcan (Naloxone): opioid OD Flumazenil: benzo OD Oxygen
2
Q
Drug removal treatment
A
Dialysis
Urinary manipulation
3
Q
Questions for Tylenol OD
A
When did OD occur? Single ingestion vs multiple ingestions? Co-ingestants? Tab strength? Number of tabs? Do we have the bottle?
4
Q
Orders for Tylenol OD
A
cbc cmp pt ptt ekg 4 hr tylenol level uds etoh ucg ua asa level
5
Q
poison control number
A
800-222-1222
6
Q
Tylenol metabolism
A
<5% by cytochrome P450
7
Q
What is the danger of tylenol OD?
A
- saturation of cP450 system
- glutathione depletion
8
Q
Stage 1 tylenol OD
A
24 hrs
N/V, malaise
minimal signs/symptoms
9
Q
Stage 2 tylenol OD
A
48-72 hrs
most will recover even w/o treatment
RUQ pain
elevated LFT’s
10
Q
Stage 3 tylenol OD
A
72-96 hrs fulminant liver failure coagulopathy encephalopathy renal failure metabolic acidosis
11
Q
Stage 4 tylenol OD
A
complete recovery if survived Stage 3
12
Q
Who is glutathione deficient?
A
alcoholics
AIDS
13
Q
Tylenol toxicity
- single ingestion
- 24 hr tox
A
140mg/kg single ingestion
7.5g/24 hrs
14
Q
What contraindicates Rumack-matthew nomogram?
A
multiple ingestions
extended release
15
Q
Tylenol OD treatment
A
ABC’s
Charcoal
Mucomyst (NAC, N-acetylcysteine)
