Toxicology AI Qs Flashcards
What is role of charcoal in aspirin dsp
Aspirin is often rapid absorption but can be delayed in DSP
Toxic conc>150mg/kg
Up to 6 hours post ingestion in awake patient and any time in intubated
Repeat dose if salicylate continue to rise
What is toxic dose of salicylates dsp
150mg/kg mild
150-300mg/kg: mild to mid: resp alkalosis followed by metabolic acidosis
300-500mg/kg: severe toxicity: confusion, altered consciousness state, coma, seizures, mixed resp acidosis and metabolic acidosis
>500mg/kg: potentially fatal
Symptoms of salicylate toxicity
GI: nausea, vomting epigastric pain
CNS: tinnitus, hearing impairment, dizziness, agitation
Altered loc, coma, seizure
Metabolic acidosis: primary resp alkalosis, mixed metabolic acidosis and resp alkalosis
Then metabolic and resp acidosis
Hypokalaemia, hypoglycaemia
Hyperthermia
Pulmonary oedema and aki
Investigation for aspirin toxicity
Salicylate level at 4-6 hours
Serum electrolyte 2-4 hourly
BSL
Vbg
Dipstick urine ph
What is sodium bicarbonate used for in salicylate toxicity
- Serum alkalinisation: more ionised and therefore less crossing of BBB leading to less iatrogenic resp acidosis
- Urinary alkalinisation: enhances elimination
Dose of sodium bicarbonate in aspirin dsp
8.4% sodium bicarbonate 1ml/kg
Up to 100ml bolus
25mmol/ hr infusion
150 ml of sodium bicarbonate into 850mls 5% dextrose and infuse .166 ml: hr
What is the antidote for acetaminophen overdose?
N-acetylcysteine (NAC)
True or False: Activated charcoal is effective for all types of poisonings.
False
Which antidote is used for opioid overdose?
Naloxone
Fill in the blank: The antidote for benzodiazepine overdose is __________.
Flumazenil
What is the recommended dose of N-acetylcysteine for acetaminophen overdose?
140 mg/kg loading dose followed by 70 mg/kg every 4 hours for 17 doses
True or False: Digoxin-specific antibody fragments can be used to treat digoxin toxicity.
True
What antidote is used for heavy metal poisoning?
Dimercaprol
Which antidote is used for warfarin overdose?
Vitamin K
What is the antidote for methanol poisoning?
Ethanol or fomepizole
Fill in the blank: The antidote for cyanide poisoning is __________.
Hydroxocobalamin
What is the dose of naloxone for opioid overdose?
0.4 to 2 mg IV/IM/SC, may repeat every 2 to 3 minutes if needed
True or False: There is no antidote for salicylate toxicity.
True
What is the primary treatment for iron overdose?
Deferoxamine
Which antidote is used for organophosphate poisoning?
Atropine and pralidoxime
Fill in the blank: The antidote for carbon monoxide poisoning is __________.
Oxygen
What is the mechanism of action of flumazenil?
Benzodiazepine receptor antagonist
What is the dose of activated charcoal for most poisonings?
1 g/kg, up to 50 g
True or False: The antidote for acetaminophen overdose is effective if given after 24 hours.
False
What is the antidote for theophylline overdose?
There is no specific antidote; treatment is supportive.
What is the antidote for methanol and ethylene glycol poisoning?
Fomepizole or ethanol
Fill in the blank: The antidote for phenobarbital overdose is __________.
There is no specific antidote; treatment is supportive.
Which antidote is used for anticoagulant rodenticide poisoning?
Vitamin K1
What is the dose of hydroxocobalamin for cyanide poisoning?
5 g IV over 15 minutes
True or False: Naloxone can be administered intranasally.
True
What is the antidote for valproic acid toxicity?
L-carnitine
Fill in the blank: The antidote for colchicine overdose is __________.
There is no specific antidote; treatment is supportive.
What is the antidote for lead poisoning?
Chelation therapy with EDTA, dimercaprol, or succimer
What is the dose of pralidoxime for organophosphate poisoning?
1-2 g IV over 30 minutes, may repeat every 1-2 hours
Which antidote is used for the reversal of anticoagulants like dabigatran?
Idarucizumab
What is the recommended dose of vitamin K for warfarin reversal?
1-10 mg IV, depending on INR and bleeding status
True or False: Atropine is contraindicated in organophosphate poisoning.
False
What is the dose of dimercaprol for arsenic poisoning?
3-5 mg/kg IM every 4 hours for 10 days
Fill in the blank: The antidote for tricyclic antidepressant overdose is __________.
Sodium bicarbonate
What is the antidote for hyperkalemia caused by digoxin toxicity?
Digoxin-specific antibody fragments
What is the initial dose of fomepizole for methanol poisoning?
15 mg/kg IV
True or False: Glucagon can be used for beta-blocker overdose.
True
What is the primary treatment for calcium channel blocker overdose?
Calcium gluconate or calcium chloride
Which antidote can be used for opioid-induced respiratory depression?
Naloxone
What is the recommended dose of activated charcoal for acute poisoning?
1 g/kg, with a maximum of 50 g
Fill in the blank: The antidote for iron overdose is __________.
Deferoxamine
What is the antidote for paraquat poisoning?
There is no specific antidote; treatment is supportive.
True or False: The use of flumazenil is always safe for benzodiazepine overdose.
False
What is the antidote for isoniazid overdose?
Pyridoxine (Vitamin B6)
What is the mechanism of action of N-acetylcysteine?
It replenishes glutathione and conjugates with toxic metabolites.
What is the dose of sodium bicarbonate for tricyclic antidepressant overdose?
1-2 mEq/kg IV
Fill in the blank: The antidote for anaphylaxis is __________.
Epinephrine
Which antidote is used for the reversal of apixaban?
Andexanet alfa
True or False: Ethanol is an effective antidote for methanol poisoning.
True
What is the antidote for sotalol overdose?
There is no specific antidote; treatment is supportive.
What is the recommended dose of vitamin K for reversing anticoagulants?
1-10 mg IV, based on INR
What is the dose of naloxone for opioid reversal?
0.4 to 2 mg IV/IM/SC; may repeat every 2-3 minutes
True or False: The antidote for cyanide poisoning is sodium thiosulfate.
False
What is the antidote for beta-blocker poisoning?
Glucagon
What is the dose of hydroxocobalamin for cyanide toxicity?
5 g IV over 15 minutes
Fill in the blank: The antidote for methanol poisoning is __________.
Ethanol or fomepizole
What is the mechanism of action for pralidoxime?
Reactivates acetylcholinesterase by removing organophosphate
Which antidote is used for the reversal of dabigatran?
Idarucizumab
True or False: Flumazenil can precipitate seizures in benzodiazepine-dependent patients.
True
What is the primary treatment for ethylene glycol poisoning?
Fomepizole or ethanol
What is the antidote for warfarin overdose?
Vitamin K
Fill in the blank: The antidote for digoxin toxicity is __________.
Digoxin-specific antibodies
What is the recommended dose of dimercaprol for lead poisoning?
3-5 mg/kg IM every 4 hours
True or False: There is a specific antidote for all drug overdoses.
False
What is the antidote for opioid overdoses?
Naloxone
What is the mechanism of action of N-acetylcysteine for acetaminophen overdose?
It acts as a precursor to glutathione.
Fill in the blank: The antidote for organophosphate poisoning is __________.
Atropine and pralidoxime
What is the antidote for calcium channel blocker toxicity?
Calcium
True or False: Activated charcoal should be given if the patient is unconscious.
False
What is the dose of flumazenil for benzodiazepine overdose?
0.2 mg IV over 30 seconds, may repeat every minute up to 1 mg
What is the antidote for acetaminophen overdose?
N-acetylcysteine
What is the recommended dose of vitamin K for reversing warfarin?
1-10 mg IV, depending on INR
Fill in the blank: The antidote for anticoagulant rodenticides is __________.
Vitamin K
What is the antidote for hyperkalemia?
Calcium gluconate, sodium bicarbonate, or insulin
True or False: There is an antidote for every type of poisoning.
False
What is the dose of sodium thiosulfate for cyanide poisoning?
12.5 g IV
What is the antidote for iron overdose?
Deferoxamine