Treating Toxicity Flashcards
What is more likely to occur in poisoning, hypertension or hypotension?
Hypotension
Treat by elevating foot of bed and giving IV sodium chloride or a colloid to increase plasma volume.
If someone is having a convulsion as a result of an overdose/ poisoning, what can be done?
Leave if under 5 mins
IV diazepam or lorazepam (NB benzo’s should NOT be given by IM route)
If IV not available:
Buccal midazolam (not licensed for adults or children unfer 3 months)
Rectal diazepam
What is activated charcoal effective at reversing?
Poisons in the GI system, reduces absorption, the sooner its given the better, efficacy reduced after 1 hour after ingestion of poison.
Repeated doses of charcoal effective for: Carbamazepine, phenobarbital, quinine, theophylline, dapsone.
Symptoms of aspirin poisoning? How to treat?
hyperventilating
tinnitus!!!
deafness !!!
sweating
TREAT USING CHARCOAL, SODIUM BICARBONATE TO INCREASE URINARY EXCRETION, CORRECT K+ CONC BEFORE GIVING THIS.
What are the early symptoms of paracetamol poisoning? what is the antidote?
Nausea and vomiting
Liver damage at its max 3-4 days after
Acetylcysteine - most effective when given up to 8 hours after ingestion
How to treat antidepressant overdose?
Activated charcoal to limit absorption
Sodium bicarbonate to stop arrhythmias
How could you treat Dystonias resulting from overdose of phenothiazines and related drugs?
Procyclidine
or Diazepam
Overdose of benzo’s?
Flumazenil
Overdose of beta blockers?
Atropine IV- corrects bradycardia
How do we treat Calcium channel blocker overdose?
Charcoal
Calcium chloride
Calcium gluconate
Atropine for bradycardia
How to treat Lithium toxicity?
Heamodyalisis
increase fluid intake to increase urine output (but don’t use diuretics)
How to manage Cocaine overdose?
IV Diazepam to reduce agitation
Cooling measures for hyperthermia
Similar treatment for ecstasy (MDMA) poisoning
What is the treatment for an Iron overdose?
desferrioxamine mesilate
What are the signs of lithium toxicity? What about if it is severe (i.e. plasma conc over 2.0)?
Vomitting Diarrhoea Ataxia (uncontrolled body movement) Tremor Twitching Slurred speech
Severe: Convulsions Coma renal failure hypotension
What are the signs of Theophylline toxicity?
Hint: theophylline comes from the same family as caffeine. Think what happens when you took too many pro plus?! Agitation Restlessness Dilated pupils Tachycardia Vomiting Hyperglycaemia
Severe hypokalaemia may also develop
How is theophylline toxicity managed?
Repeated doses of activated charcoal
Manage hypokalaemia with Infusion of potassium chloride
Short acting beta blocker e.g. esmolol for severe tachycardia
Somebody has been stung by a bee and has had a severe anaphylactic reaction to it. How should this be managed?
Epipen
IM adrenaline/ epinephrine
Signs of digoxin toxicity?
Nausea & vomiting & diarrhoea abdominal pain dizziness & confusion, delirium vision disturbance (blurred or yellow vision). Cardiac disturbance: irregular heartbeat ventricular tachycardia
What is the antidote for digoxin toxicity?
DigiFab
A digoxin specific antibody
What is the reversal agent for heparin toxicity?
Protamine sulphate injection
What is methaemoglobinaemia? What is the reversal agent?
Higher than normal level of methemoglobin in the blood caused by oxidative stress. Methemoglobin results in a reduced ability to release oxygen to tissues and thereby hypoxia (tissue death) occurs.
Reversal agent: Methylthioninium chloride injection
Treatment of iron poisoning?
Desferrioxamine mesilate (Deferoxamine) Used for hemochromatosis, a disease of iron accumulation that can be either genetic or acquired
