Week 11 - Overdose Flashcards
- What is the Risk Assessment Approach?
A distinct cognitive approach in which you attempt to predict the likely clinical course and potential complications for the individual.
- Resuscitation: ABC, control seizures, hypoglycaemia, hyperthermia, consider resuscitation antidotes
- Risk assessment: agent, dose, time since ingestion, clinical features, pt factors
- Support care: screening, 12 lead, specific substance
- Treatment/decontamination: decontamination does not take priority over CPR
- Disposition of the pt:
- What are the main types of CNS depressants?
- Opiates - morphine, heroin, codeine, tramadol, methadone
- Sedative-hypnotic drugs - benzos and barbiturates
- GHB
- Alcohol
- What are the key factors of Naloxone?
- Competes for same receptors as opiates - greater affinity
- Shorter half life than opiates
- Administer after looking after the airway
- Consider size of pt to determine initial dose
- What is the clinical presentation of opioid OD?
Lowered LOC, respiratory depression, pinpoint pupils, hypotension, vomiting
- What is the clinical presentation of alcohol OD?
CNS depression, loss of inhibition, loss of judgement, vomiting, increase in confidence, agitation, slurred speech, ataxia, tachycardia, hypothermia, inhibition of anti-diuretic hormone (increase in urine production) which leads to hypotension and loss of electrolytes
- What are the main complications of long term alcohol use?
- Cardiovascular - Afib, cardiomyopathy, clotting problems
- GIT - liver disease, hepatitis, cirrhosis, oesophageal varices
- Malnutrition, vitamin deficiency
- Alcoholic ketoacidosis,
- CNS - memory problems, subdural haemorrhage
- What are some complications when withdrawing from alcohol?
- Autonomic excitation - tremors, sweating, anxiety, agitation
- Neuro excitation - hyper-reflexia, hallucinations, seizures, nightmares
- Delirium tremens - Severe alcohol withdrawal symptoms such as shaking, confusion and hallucinations. Usually starts two to five days after the last drink and it can be fatal.
- What are common sources of methanol?
Antifreeze, automobile/furniture polish, pesticides, industrial products, paint thinners, methylated spirits
- Leads to optic nerve demyelination
- What are the clinical signs of methanol poisoning?
- Early symptoms: CNS depression, loss of inhibition, ataxia, nausea
- possibility of seizures
- vision blurring or loss
- metabolic acidosis
- death
- What are some of the immediate and long term effects of MDMA use?
- Immediate: dilated pupils, increased HR and BP, euphoria, teeth grinding, anxiety, overheating, dehydration, n/v, serotonin syndrome
- Long term: dependence, depression, memory impairment, liver problems
- what are some of the short and long term effects of Ice use?
- Short term: Feelings of pleasure, increased alertness, scratching, dilated pupils, dry mouth, sweating, rapid HR and breathing, reduced appetite
- Long term: extreme weight loss, restless sleep, dental problems, anxiety, heart and kidney problems, increased risk of stroke
- What are some of the short term and long term effects of cocaine use?
- short: confidence, reduced appetite, dry mouth, high BP, high temp, indifference to pain
- long: insomnia, depression, sexual dysfunction, hypertension, heart disease, erosion of nasal septum
- What are some cardiovascular effects of CNS stimulants?
- Toxicity - sympathomimetic, vasospastic and sodium channel blocking
- Vasospasm - poor myocardial perfusion
- Acute cardiomyopathy
- Pulmonary oedema
- What is a major complication of CNS stimulants?
Hyperthermia - can be sign of serotonin syndrome and can lead to rhabdomyolysis, impaired consciousness, DIC, multi-organ failure
- What is Serotonin syndrome?
Too much serotonin in the brain and peripherally - through either its release or blocking of re-uptake.
Leads to: confusion/hallucinations, agitation, dilated pupils, headache, n/v, rapid HR, high BP, tremor, seizures, diaphoresis
Life threatening if: high fever, seizure, rigid muscles, irregular heartbeat, unconsciousness
