Toxicology Flashcards
What are the most common two drug overdoses?
- Paracetamol2. Quitiapine (seroquel)Other:AlcoholDigoxinBenzoOxycodone
What are the management options for drug OD?
• Decrease absorption: charcoal, stomach pump, whole bowel irrigation (life threatening) • Physiological antagonist: atropine for organophosphate• Bicarbonate: aspirin OD; anticonvulsants OD; sodium channel blockers• Direct antagonist:• Antidote: naloxone
Pathophysiology of paracetamol toxicity
Depletion of glutathione anti-oxidant leads to NAPQI produced leading to hepatocellular necrosis
What paracetamol dose can lead to toxicity?
> 400mg/kg
What is the antidote for paracetamol toxicity?
• Antidote 100% effective if started within 8 hours: N-acetylcysteine (NAC)o IV infusiono Weight based infusion, independent of how much was takeno AFx: anaphylactic
How do you manage a toxicology patient?
Supportive care for 95% of cases (ABCDE * mainly breathing), assess by GCS.Usually wait for it to wear off if between 11-13 GCS.If GCS
How does a SSRI OD present?
Massive clonusNystagmus
What are the mechanism of toxicity of venomous creatures of Australia?
Neurotoxicity (muscle paralysis - normally just keep them on ventilation until toxic leaves)CardiotoxicityEye
How do you die from brown snake?
Coagulopathy (DIC pattern) - massive bleeding from every orifice
Rx of snake bites
Antidote
Ix of snake bites
Venom detection kit * but do not go on the results of this, go on the clinical signs
Most lethal animal?
Box jelly fish: cardiotoxic causing asystole within minutes
Common spiders
Funnel web spider (mostly in NSW)Red-backs (doesn’t actually kill; severe pain)
Irikanji MoA?
irikanji - catacholamine surge, fatal in IHD patients
