Toxicology

Question 1

Essential INV

Answer 1

1. BGL
2. LFTs
3. Paracetamol levels
4. blood alcohol levels
5. CBE, elctrolytes, ABG, ECG

Question 2

paracetamol OD levels

Answer 2

• 10-15g is normal
• 4-6g for alcoholics and anticonvulsants

Question 3

paracetamol OD effects

Answer 3

1st 24 hours : N&V (normally within 4-12hours)

24-48hours: asymptomatic but ongoing hepatic necrosis

Question 4

paracetamold OD Rx

Answer 4

• lavage if <2hours
• then activated charcoal
• Normogram >150mg/kg NAC

Question 5

paracetamol OD: mech of NAC

Answer 5

promotes hepatic glutathione regeneration

Question 6

how to give naloxone

Answer 6

small increment of 200mg

sudden reversal will lead to severe and dangerous withdrwal symptoms w aggresion

Question 7

flumazenil contra

Answer 7

if not know TCa taken - intractable seizure

Question 8

Large pupils, 3 classes of drugs with examples

2 area of brain which can be damage to cause it

Answer 8

Sympathomimetics e.g amphetamines

anticholinergics e.g antihistamines, TCA

Retinal toxicity e.g methanol, quinine

midbrain or brainstem (can be large or small)