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36 Cards in this Set
- Front
- Back
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List decontamination procedures used in a hospital:
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Gastric lavage (if ingestion within past hour)
- Contraindicated if corrosive or hydrocarbon agent Activated charcoal Cathartics Whole bowel irrigation |
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Activated charcoal is NOT effective for the treatment of the following toxicities:
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Iron
lead lithium simple alcohols corrosives Not recommended with hydrocarbons |
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Activate Charcoal dose
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Given within first hour
< 1 YO: 1 gm/kg 1 – 12 YO: 1 – 2 gm/kg OR 25 – 50 grams Adolescent/Adult: 25 – 100 grams |
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How to dosage combination products of activated charcoal and sorbitol?
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OK in the first dose of Act. Charcoal but Do not include sorbitol if a second dose of activated charcoal is necessary
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Cathartics agents to treat toxic ingestion:
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Saline (infants)
Mag Citrate Sorbitol |
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Agent to use in whole-bowel irrigation:
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Polyethylene glycol electrolyte solutions
(intact GI required) |
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When does a multiple dose a charcoal may be necessary?
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Reserved for life-threatening exposures to certain drugs
Enhance passage from bloodstream into GI tract Interrupts enterohepatic recirculation |
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Multiple dose charcoal:
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< 1 YO: 1 gm/kg every 1 – 4 hr
1 – 12 YO: 1 – 2 gm/kg OR 15 – 30 gm every 2 – 6 hr Adolescents/Adults: 1 – 2 gm/kg OR 25 – 60 gm every 2-6 hr |
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Systemic antidote for APAP toxicity:
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Acetylcysteine
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Systemic antidote for Anticholinesterase insecticides toxicity:
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Atropine
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Systemic antidote for Botulism:
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Botulsim antitoxin
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Systemic antidote for lead poisoning:
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Calcium EDTA
Succimer |
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Systemic antidote for Iron toxicity:
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Deferoxamine
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Systemic antidote for Digoxin or digitoxin toxicity:
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Digoxin immune Fab
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Systemic antidote for various heavy metals toxicity:
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Dimercaprol
Penicillamine |
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Systemic antidote for Ethyleneglycol and methanol toxicity:
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Ethanol
Fomepizole |
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Systemic antidote for benzodiazepine toxicity:
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Flumazenil
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Systemic antidote for cyanide toxicity:
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Hydroxocobalamin
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Systemic antidote for methemoglobinemia:
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Methylene blue
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Systemic antidote for opioid toxicity:
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Nalmefene
Naloxone |
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Systemic antidote for carbon monoxide poisoning:
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Oxygen
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Systemic antidote for Vitamin K and anticoagulants toxicity:
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Phytonadione
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Systemic antidote for organophosphate insecticides toxicity:
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Pralidoxime
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Systemic antidote for radioactive iodine toxicity:
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Potassium iodine
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Systemic antidote for isoniazid toxicity:
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Pyridoxine
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Who is a greater risk for APAP toxicity?
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Adolescents and adults
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Why children less than 9-12 yo have lower incidence of hepatotoxicity after APAP toxic ingestion?
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increased sulfation and decreased glucuronidation
Spontaneous emesis Earlier tx |
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Hepatotoxic dose of APAP
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More than 7.5g
Children 150 mg/kg |
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How to manage APAP toxicity within 4 hrs of ingestion?
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Activated Charcoal
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Do you know how to read the APAP toxicity chart to determine the use of acethylcysteine?
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I hope you do
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When can acetylcysteine be used for APAP toxicity?
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at least 4 hrs after ingestion
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SE and ancillary txt of oral acetyldysteine:
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N/V
Metoclopramide, ondansetron, droperidol (To increase GI motility) |
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SE and ancillary txt of IV acetyldysteine
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Anaphylactoid rxn, temp acute flushing and erythema
Antihistamines and epinephrine |
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Monitoring of APAP toxicity treatment:
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LFT’s, serum Cr, UA
Every 24 hrs for 96 hrs |
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Agents with potential to induce metabolic acidosis:
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M - Methanol
U – Uremia D – Diabetic ketoacidosis P – Propylene glycol / Paraldehyde I – Isopropyl alcohol / Isoniazid L – Lactic acid / Lithium E – Ethylene glycol/Ethanol S – Salisylates |
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What is the maximum dosage of acetyldysteine for IV and Oral?
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IV - 21 hours 300 mg/kg
Oral - 72 hours - 1330 mg/kg |
