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20 Cards in this Set
- Front
- Back
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If you suspect a benzo overdose what do you give them?
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Flumazenil
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If you suspect an opioid OD, what do you give?
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Naloxone
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If you suspect an alcohol OD what drug can you give?
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Thiamine (B1)
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What is recommended to be given to pts that come in with unknown cause of coma
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Dextrose (for glucose crash)
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What should you give for a pt who has acute poisoning?
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Activated Charcol
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when is emptying the stomach useful in ingestion?
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Emptying the stomach is most effective … If done in the FIRST HOUR AFTER INGESTION
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When is ipecac used?
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Sometimes used to treat ingestions at home under telephone supervision of physician or poison control center personnel
like if they are really far from the hospital |
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how long does ipecac take to work? what is a side effect?
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20-30 minutes for 1st episode
can have tox effects on the heart Irritates GI tract and stimulates CTZ |
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When should vomiting not be induced?
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Altered mental status (unconscious, stupor, delirium)
<6 months old Inability to protect airway (no gag reflex) Ingestion of agents causing a rapid change in mental status, convulsants, TCA, CNS stimulants further stimulation may precipitate convulsions Ingestion of acids, alkali (drain cleaners), petroleum products, sharp objects |
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a pt ingests petroleum products, he calls you and asks if he should take ipecac because he is a few hours from the hospital..what do you tell him?
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induced vomiting is contraindicated in petroleum products
get yo ass to the ER |
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What are 4 reasons not to use Ipecac/induced emesis?
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Aspiration ... chemical pneumonitis
Prolonged vomiting ... that won’t stop (most common problem) Complicates further PO treatments you may need to initiate Vagal-induced bradycardia Esophageal tearing |
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When is activated charcoal most effective?
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Greatest benefit is WITHIN FIRST HOUR OF INGESTION
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WHEN CAN YOU NOT USE ACTIVATED CHARCOAL?
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CHARCOAL PHAILS
Caustics & Corrosives Heavy Metals Alcohols & glycols Rapidly absorbed substances Cyanide, chlorine Other insoluble drugs Aliphatic hydrocarbons Laxatives Pesticides, potassium Hydrocarbons Acids, alkali, alcohols Iron, insecticides Lithium Solvents |
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When is gastric lavage indicated?
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Use when activated charcoal (AC) unlikely to work or large amount of pills ingested
like if a dude took 50 acetaminophen |
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what is your biggest concern when using gastric lavage? there are 3 others
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Aspiration
others: Esophageal perforation Intratracheal insertion Concretions may limit effectiveness of lavage (chunks too darn big!!!) note: do not use it for large/sharp foreign bodies |
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How are osmotic cathartics used in management of poisoning?
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these are laxatives
Quicken passage time through GI track Minimizes absorption increased water & electrolyte conc in colon Often used with activated charcoal |
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What is forced osmotic diuresis? What is used?
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Mannitol
decreased reabsorption and increased flow through renal tubule Once popular – now not recommended May cause volume overload and electrolyte abnormalities |
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When is urine alkalinization 1st line tx?
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for moderate salicylate poisoning (aspirin)
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What limits the use of hemodialysis? what is it used for?
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Used for severe poisonings
NOT USEFUL FOR DRUGS WITH LARGE Vd |
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What is a serious potential side effect of Flumazenil? (what was this used for again?)
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Antidote for benzodiazepine overdose
May produce seizures in BDZ dependent tolerant patients |
