Toxins Flashcards
Generic treatment of toxins
Activated charcoal (efficacy decreases over time) only give if airway intact!
Whole bowel irrigation (polyethylene glycol) (sustained release or enteric coated drugs)
Urine alkalinisation (sodium bicarb)
Haemodialysis
Specific antidotes
Doses of naloxone
IV 400mcg
IM 800mcg
SC 800mcg
IN 2mg
Can titration to total dose of 10mg or infusion if longer acting preparations of opioid taken
Symptoms opioid toxidrome
resp depression
Decreased GCS
Pinpoint pupils
Antidote to benzos
Flumazenil
Benzo toxidrome
Decreased GCS
resp depression
Hypotension
Risk of using flumazenil
Risk of seizure
Arrhythmia
Hypotension
Withdrawal
Symptoms of TCA overdose
Hypotension
Seizures
Coma
Arrhythmias
Anticholinergic (dry skin, dilated pupils, fever, tachycardia, ileus, urinary retention)
Mechanism of cardiac toxicity in TCA overdose
Anticholinergic (tachycardia)
Sodium channel blockade
ECG changes in TCA overdose
RAD
Widened QRS
Treatment in TCA overdose
Sodium bicarb
Local anaesthetic toxicity effects:
Agitation
Decreased GCS
Seizure
Bradycardia - conduction blocks - asystole but also VT
Treatment of local anaesthetic toxicity
Lipid emulsion IV 20% infusion
Stimulant overdose symptoms
Agitation
Tachycardia
Hypertensive crisis
Hyperthermia
Angina/ACS
Useful first line for stimulant overdose
Benzos
Treatment in organophosphate poisoning
Atropine
