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29 Cards in this Set
- Front
- Back
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What are the clinical features of opioid overdose? |
1) miosis 2) CNS depression 3) respiratory depression |
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What are the clinical features of serotonin syndrome? |
1) CNS (agitation, confusion, coma) 2) autonomic instability (mydriasis, flushing, diaphoresis, hyperthermia, tachycardia, hypotension, hypertension) 3) neuromuscular hyperactivity (hyperreflexia / rigidity / myoclonus) |
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What are the major differences between serotonin syndrome and neuroleptic malignant syndrome? |
1) NMS occurs after prolonged exposure to neuroleptics or after withdrawal of dopamine receptor agonists 2) NMS develops over days to weeks 3) NMS does not cause mydriasis, diarrhoea, myoclonus |
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What are the clinical features of anticholinergic syndrome? |
1) mad as a hatter (delirium) 2) hot as hell (hyperthermia) 3) red as a beet (flushing) 4) dry as a bone (dry mouth, urinary retention) 5) blind as a bat (dilated pupils, blurred vision) 6) tachycardia / arrhythmia 7) seizure |
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What are the clinical features of salicylate poisoning? |
1) tachypnoea 2) nausea and vomiting 3) tinnitus 4) hyperthermia 5) agitation / confusion 6) pulmonary and cerebral oedema 7) coma / death |
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What ECG changes are seen in tricyclic antidepressant overdose? |
1) widened QRS 2) R-axis deviation 3) tachycardia 4) heart block 5) ventricular arrythmia |
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What are the clinical features of tricyclic antidepressant overdose? |
1) anticholinergic 2) altered level of consciousness and seizure 3) cardiac arrythmia |
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What are the clinical features of acute iron overdose? |
1) haemorrhagic gastroenteritis (vomiting, abdominal pain, bloody diarrhoea) 2) systemic toxicity (lethargy, hypotension, metabolic acidosis, liver and renal failure, seizures, coma) |
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In what toxicity is hydroxocobalamin used as an antidote? |
Cyanide |
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What might you see on the ECG of a patient with carbon monoxide poisoning? |
Ischaemic changes |
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What is the specific antidote to carbon monoxide poisoning? |
High-flow / high-concentration oxygen |
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What is the specific antidote for paracetamol poisoning? |
N-acetylcysteine |
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What is the specific antidote for organophosphate poisoning? |
Atropine |
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What is the antidote for the membrane-depressant cardiotoxic effects (wide QRS, hypotension) of tricyclic antidepressants? |
Sodium bicarbonate |
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What is the specific antidote for calcium channel blocker poisoning? |
Calcium |
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What is the specific antidote for iron poisoning? |
Deferoxamine (chelating agent) |
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What is the specific antidote for digoxin poisoning with serious arrythmias and/or hyperkalaemia? |
Digoxin antibodies |
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What is the specific antidote for caffeine poisoning? |
Beta-blocker |
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What is the specific antidote for methanol poisoning? |
Ethanol or fomepizole |
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What is the mechanism of action of fomepizole? |
Competitive inhibitor of alcohol dehydrogenase (slows production of toxic metabolites) |
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What is the specific antidote for benzodiazepine overdose? |
Flumazenil (contraindicated in patients with seizures, benzodiazepine dependence, or tricyclic overdose as can precipitate seizures) |
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What is the antidote for beta-blocker overdose? |
Glucagon (raises cardiac myocyte cAMP independent of beta-adrenoceptors) |
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What is the specific antidote for opioid overdose? |
Naloxone |
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What are some drug overdoses for which haemodialysis is useful? |
1) carbamazepine 2) ethylene glycol 3) lithium 4) methanol 5) metformin 6) phenobarbital 7) salicylate 8) theophylline 9) valproate |
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What are some drug overdoses for which haemodialysis is NOT useful? |
1) amphetamines 2) antidepressants 3) antipsychotics 4) benzodiazepines 5) calcium channel blockers 6) digoxin 7) metoprolol and propranolol 8) opioids |
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What are the clinical features of cyanide poisoning? |
1) dyspnoea 2) agitation 3) tachycardia 4) seizures 5) coma 6) hypotension 7) severe metabolic acidosis 8) death |
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What are the clinical features of digoxin overdose? |
1) nausea and vomiting 2) hyperkalaemia 3) cardiac arrythmias (sinus bradycardia, AV block, ventricular arrythmias, etc) |
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What is the primary mechanism of toxicity of tricyclic antidepressants? |
Competitive antagonists at muscarinic cholinergic receptors |
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How is paracetamol metabolised? |
With normal doses the majority (>80%) is by glucoronidation or sulfation to inactive metabolites; secondary pathway involves hydroxylation to toxic metabolite (NAPBQI) which is conjugated with glutathione to produce inactive metabolites |
