Overdose And Rescue Meds

Front 1

Acetaminophen

Back 1

Acetylcysteine Acedote, Mucomyst

Hint 1

PO
• Loading 140mg/kg
• Maintenance 70mg/kg Q 4H

IV
• Loading 150mg/kg in 200ml D5W infused over 1 hour
• Dose 2 50mg/kg in 500ml D5W over 4 hours
• Dose 3 100mg kg in 1000ml D5W over 16hours

Front 2

Sulfonylureas (Oral Hypoglycemics)
• glipizide, glyburide, and glimepiride

Back 2

1)Dextrose
2) Sandostatin

Hint 2

• 1) IV 400-600mg/kg/hour
• 2)IV 50-100 mcg IVP over 3 min

Front 3

Muscarinic Agonists (anticholinergics)
• Bethanocol (Urinary retention)
• Cholinesterase inhibitors (Neostigmine for myasthenia gravis)
• Some mushrooms
Organophosphate poisoning
Carbamate poisoning
(strange or confused behavior, wheezing, sialorrhea, muscle fasciculations, involuntary urination/defecation, convulsion, unconsciousness)

Back 3

Atropine Atropen

Atropine + pralidoxime + Benzodiazipine

Hint 3

IM
• Atropen contains 2mg/dose -1 dose for mild poisoning to 3 for severe

IV
• Pralidoxime 1-2gm over 20 min then 500mg/hour

Front 4

ntimuscarinc agonists (Cholinergics)
• Atropine
• Antihistamines (diphenhydramine)
• Phenothiazines (promethazine)
(Dry mouth, blurred vision, photophobia, hyperthermia, hallucination, delerium, hot dry skin, respiratory depression)

Back 4

Physostigmine Lirium (ACHesterase inhibitor)

Hint 4

IV
0.5-2mg slow push NTE 1mg/min then 1-4mg Q 30-60min PRN

Front 5

Digoxin

Back 5

Digoxin immun fab
Digibind
na-hco3, stop dig, normalize k, lidocaine (for torsades), anti-digitalis Fab

Hint 5

• Unknown quantity 20 vials 10/10
• Known quantity: Totl load/o.5mg per vial = number of vials
• Chronic therapy toxicity: 6 vials

Front 6

Warfarin Coumadin
(↓BP, ↑HR, bruises, petichiae, hematomas, red/black stools, cloudy discolored urine, HA, panting

Back 6

Vitamin K1

Hint 6

PO is best but if IV DILUTE in NS and NTE 1mg/min
• INR 5-9: 2.5mg PO
• INR 10-20: 5mg PO
• INR>20: 5-10mg IV

Front 7

Heparin

Back 7

Protamine Sulfate

Hint 7

IV slow NTE 50mg/10 min
• 1mg neutralizes 100 unit heparin

Front 8

Insulin
(Hypoclycemia)

Back 8

Glucagon (if no IV for Dextrose)
Dextrose

Hint 8

• IM/SQ/IV 0.5-1mg
• IV D50 25g

Front 9

Methotrexate

Back 9

Leucovorin

Hint 9

• IV 1:1 ratio within 1 hour

Front 10

Calcium Channel Blocker Overdose
(Diltiazem, Cardiazem / Amlodipine, Norvasc / Nifedipine, Procardia

Back 10

Calcium Chloride

Hint 10

• 1-2g IV infused over 10 min Q20min prn up to 5 doses

Front 11

Magnesium toxicity
Nausea
Vomiting
Skin flushing
Weakness
Lightheadedness

Back 11

Calcium Gluconate

Hint 11

• 500-800 mg IV q10min

Front 12

Opiate Toxicity

Back 12

Nalaxone Narcan

Hint 12

2mg IV, IM, SQ, ETQ 2-3min PRN up to 10mgTypically every 1-2 hours

Front 13

Benzodiazepine Toxicity

Back 13

Flumazenil Romazicon

Hint 13

0.2-0.5mg Ivp over 30 sec up to 3mg/hour