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37 Cards in this Set
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Anticholinergic syndrome (agitated delirium) - Antimuscarinic |
CENTRAL
Confusion
Restlessnees
PERIPHERAL
Mydriasis
Tachycardia
Dry skin
Flushing
Hyperthermia
Urinary retention
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Snake poisoning |
Venom induced coagulopathy - Brown, Tiger, Taipan
Neurotoxic -Taipan, death adder
Myotoxicity - Black, sea snake |
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Nicotinic effects |
Fasciculation Tremor Weakness Respiratory muscles paralysis Tachycardia Hypertension Agitation, coma, seizures |
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Opioid toxidrome |
CNS depression Respiratory depression Miosis |
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Multi dose activated charcoal indications |
Carbamazepine coma Phenobarbitone coma Dapsone overdose with methaemoglobinaemia Quinine overdose Theophylline overdose |
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Quinine overdose - cinchonism |
Cinchonism
- vomiting
- Tinnitus - Vertigo
- Deafness + blindness + hypoglycemia + Tdp/arrythmias/wide qrs |
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Salicicysm |
Vomiting
Tinnitus
Hyperventilation (Deafness) |
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Carbon monoxide poisoning |
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Indications for HBO, carbon monoxide toxicity Rx |
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QT Prolongation Drugs
Blockade of potassium efflux. |
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Class 1a antiarrythmics- quinidine, procainamide.Class 1c anti-arrythmics- flecanide (starts with f for Francis).NB: lignocaine not included.
Class 1c antiarrythmics- flecanide (starts with f for Francis). NB: lignocaine not included.
Antipsychotics- quetiapine, haloperidol
TCA's - amitriptyline, nortriptyline
Antibiotics (macrolides): erythromycin, azithromycin
Antihistamines: loratadine
Quinine
Methadone |
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Chronic Lithium toxicity (neuro signs) |
A |
Hansen and Amsiden classification - Grade 1 (mild) Tremor, increased reflexes, agitation. - Grade 2 (moderate) Stupor, rigidity, Increased tone, hypotension - Grade 3 Coma, seizures, myoclonus. |
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One tablet can kill in Paeds |
Amphetamines Baclofen Calcium channel blockers 160, 180mg Carbamazepine 400mg Chloroquine and hydroxychloroquine Clozapine Opiods Propranol 160mg Sulfonylureas Theophyline TCA'S Venlafaxine XR 150mg |
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One sip can kill Paeds |
Organophosphate and carbonate insecticides. Paraquat/Diquat. Hydrocarbons eg eucalyptus oil. Camphor Corrosives Naphthalene (one mothball) - contain paradichlorobenzene. Strichnine |
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Indications for liver transplant center transfer in paracetamol overdose |
Inr > 3.0 @ 48hrs Oliguria or creatinine > 200 Acidosis with Ph < 7.3 post resuscitation Hypoglycemia SBP < 80 Encephalopathy Severe thrombocytopenia |
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Indications for dialysis in salicylate toxicity |
Salicylate level > 4.4 (60mg/dL) Severe acidemia Renal failure
Altered GCS Unable to alkalinise urine |
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Indications for endoscopy in Corrosive ingestion first 24 hours) |
Persistent vomiting Oral burns Drooling Abdominal pain |
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Cholinergic syndrome 1 |
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Cholinergic 2 |
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Serotonin syndrome |
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TCA |
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Hunter criteria for Serotonin Syndrome |
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NMS VS Serotonin syndrome VS Malignant hyperthermia |
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Digoxin toxicity in overdose |
Git: N+V, Abdo pain. CVS: bradycardia slow AG, dysrythmias. CNS: lethargy, confusion, delirium |
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5 indication for Digibind 5 amps stable, 10 for unstable. |
K > 5 Cardiac arrest. Ingested dose > 10mg Dig level > 15nmol/L. Dysthrymias |
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Acute Lithium toxicity (GIT). |
Nausea. Vomiting. Abdominal pain. Diarrhoea (significant fluid losses can occur). Tremor (earliest neuro sign). |
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Activated charcoal |
Pros - useful for pot toxic dose - highly effective if taken < 1hr from ingestion.
Cons - vomiting - compromised airway. - Absent bowel sounds. - charcoal resistant toxin Complications Constipation Charcoal bezoar formation. Corneal abrasion. Staff distraction from resuscitation duties. |
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Sympathinometic syndrome 1 |
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Sympathinometic syndrome 2 |
Widened pulse pressure Sodium channel blockade |
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Snake antivenom indications |
Any hx of collapse Any abnormal INR Evidence of neurotoxicity |
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Indications for Digibind |
1) Hyperkalemia > 5.5 mmol/L 2) > 10mg digoxin ingestion 3) HDNM Unstable with unstable cardiac arrhythmia. 4) Cardiac arrest. 5) Serum digoxin > 15nmol/L |
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Corrosive ingestion complications |
Haemorrhage Perforation Fistula formation. |
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Colchine toxicity |
3 stages 1) GIT Phase - N+ V 2) MOF, BM Suppression, consumptive Coagulopathy, ARDS, confusion, oliguric renal failure, seizures etc (24 - 72hrs). 3) Recovery phase ( 6- 8 days) |
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Treatment of Paraquat Toxicity |
Consider hullers earth Consider charcoal Consider antioxidants Supportive care No treatment /palliative |
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Anticholinergic drugs |
Atropine, hyoscine ,glycopyrrolate Promethazine TCA Benztropine Droperidol Oxybutynin |
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MDAC - cons |
Ileus/perforation/obstruction Compromised airway Increased aspiration risk More complications than single dose. Absent bowel sounds, (for single dose). |
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WBI - ABC PIL |
Arsenic Body packers CCB Potassium Iron Lead |
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New NAC Regimen |
1st bag -200mg/kg over 4 hrs 2nd bag, - 100mg/ kg over 16hrs If > 30g (or > 500mg/kg) - 200mg/kg for 16hrs Toxic dose is 200mg/kg or 10grams |
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