Toxicology.

Question 1

What ABG results do we see aspirin overdose?

What is the big symptom?

What are the tests?

What is the treatment?

Answer 1

mixed metabolic and respiratory acidosis.

Aspirin levels at 4 hours with paracetamol.

Ringing ears

Alkalyse urine with bicarbonate and fluids

Question 2

What is the antidote for beta blocker over dose?

What are the side effects of this?

Answer 2

glucagon 5-10ml (for pre-filled).

they vomit, so need to watch airways

Question 3

Reverses the effects of benzodiazepine overdose?

Answer 3

Flumazenil

Question 4

How do we treat paracetamol OD?

Answer 4

charcoal if within an hour

Do paracetamol levels at 4 hours
if within 12-24 hours can give parvolex if blood levels are high enough on nomogram.
10% get urticaria so may need antihistamine.

Question 5

How do we treat cocaine toxicity?

What should we never use?

Answer 5

benzodiazepines e.g. diazepam and GTN for chest.

Beta and alpha receptors are being triggered, if we block beta, its all alpha and this can result in a hypotensive crisis

Question 6

What is organophosphate in?

What is the syndrome?

What is the treatment?

Answer 6

weedkillers - paraquat

cholinergic (cry and drool)

Atropine

Question 7

What is the syndrome associated with TCA OD?

What is the treatment? If?

Answer 7

anticholinergic: sympathetic effects plus flushing, long QT, dry and acidosis.

Sodium Bicarbonate and airway support for acidosis if long QT or shock.

Question 8

What happens in alcohol toxicity?

What is the treatment?

Answer 8

Alcohols metabolised into harmful metabolites in the liver by alcohol dehydrogenase.

Give alcohol, as that preferentially binds over methanol and ethylene glycol

Question 9

What are the symptoms of serotonin syndrome?

What is the treatment?

Answer 9

has sympathetic effects including hyperthermia and agitation +/- rhabdo in severe.
supportive and dantrolene for malignant hyperthermia