Toxicology

Question 1

22 year old female who presents to the emergency department with a paracetamol overdose. What is the best antidote?

Answer 1

N-Acetyl Cystine (NAC)

Question 2

24 year old male with a diagnosis of schizophrenia presents with fever, rigidity and autonomic instability. What is the best antidote?

Answer 2

Dantrolene

The clinical scenario is NMS. Treatment is largely supportive, but BROMOCRIPTINE (dopamine agonist) and DANTROLENE (skeletal muscle relaxant) can be used to counteract the symptoms. Dantrolene mechanism of action: A direct or indirect inhibition of the ryanodine receptor, the major calcium release channel of the skeletal muscle sarcoplasmic reticulum, is thought to be fundamental in the molecular action of dantrolene in decreasing intracellular calcium concentration.

Question 3

What would you prescribe a 34 year old female on clozapine to prevent seizures (prophylaxis)?

Answer 3

Valproate

Carbamazepine is an absolute contraindication with Clozapine due to risk of agranulocytosis

Question 4

A young female presents to the emergency department with confusion, shallow breathing and pin point pupils. What is the best antidote?

Answer 4

Naloxone

Opioid mu antagonist

Question 5

50 year old female with an overdose of citalopram. What is the best antidote?

Answer 5

No specific antidote

Question 6

37 year old man who was given diazepam IM developed hypotension and difficulty breathing. What is the best antidote?

Answer 6

Flumazenil

Benzodiazepine inverse agonist