Toxicities/Overdoses/Antidotes

Question 1

Magnesium

Answer 1

Respiratoy Depression
Cardiac Arrest
Decreased DTRs

Question 2

Benzodiazepine

Answer 2

Flumazenil antagonist

Question 3

Aspirin (salicylate)

Answer 3

Tinnitis, hypoglycemia, vomiting, hyperpnea
Respiratory Alkalosis
Metabolic Acidosis (Lactate)
*Not radioopaque on xray

Tx: alkalinize urine

Question 4

TCA overdose

Answer 4

Treat with Sodium Bicarb (protects against arrhythmias)

Question 5

Caustics (cleaners)

Answer 5

Flush out with water in high volumes

Do NOT give alkali to reverse

Question 6

CO toxicity presentation

Answer 6

Dizziness/Lightheadedness
Dyspnea
confusion
seizure
Death from MI (carboxyhemoglobin is like nonusable blood)
The PO2 will be NORMAL [O2 does not detach, it just can’t be released to tissues]

Question 7

Digoxin Toxicity

Answer 7

GI disturbances
Hyperkalemia (displaced by dig)
Visual distubance (yellow halos)
Brady (AV block), Atach, Vent. ectopy, afib

*EKG: downsloping ST seg in ALL leads

Question 8

Lead Poisoning

Answer 8

Abdominal Pain
Anemia (sideroblastic)
Renal tubule toxicity
WRIST DROP (radial neuropathy)
Memory loss/confusion
Irritability, Insomnia

*BEST DX: free erythrocyte protoporphyrin
Tx: Succimer (PO Pb chelator), EDTA and dimercaprol (parenteral)

Question 9

Ethanol/Methanol Tox

Answer 9

Give Fomepizole (block aldehyde dehyrdrogenase for further metabolite accumulation)
Dialysis for definitive removal

Question 10

Iron toxicity

Answer 10

Common in kids
RADIOOPAQUE ON XRAY
Nausea, vomiting, abdominal pain, diarrhea, hematemesis
Metabolic Acidosis with compensatory respiratory alkalosis

Question 11

Mag Sulfate Toxicity

Answer 11

Repiratory depression
Loss of DTRs
Give Calcium Gluconate

Question 12

TCA or Quinine Toxicity

Answer 12

Give sodium bicarb for cardio protection