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6 Cards in this Set

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what can happen to kids who ingest vagisil or other topical anesthetics such as hurricane spray
Methemoglobinemia (they will turn blue)

give them methyline blue
Toxic dose of acetaminophen?
150 mg/kg

Phase 1

0-24 hours after ingestion
Patients may be asymptomatic or report anorexia, nausea or vomiting, and malaise
Physical examination may reveal pallor, diaphoresis, malaise, and fatigue
Phase 2

18-72 h after ingestion
Patients generally develop right upper quadrant abdominal pain, anorexia, nausea, and vomiting
Right upper quadrant tenderness may be present
Tachycardia and hypotension indicate ongoing volume losses
Some patients may report decreased urinary output (oliguria)
Phase 3

72-96 h after ingestion
Patients may have continued nausea and vomiting, abdominal pain, and a tender hepatic edge
Hepatic necrosis and dysfunction are associated with jaundice, coagulopathy, hypoglycemia, and hepatic encephalopathy
Acute renal failure develops in some critically ill patients
Death from multiorgan failure may occur
Phase 4

4 d to 3 wk after ingestion
Patients who survive critical illness in phase 3 have complete resolution of symptoms and complete resolution of organ fa
Toxic metabolite of acetaminophen? tx?
N -acetyl-p-benzoquinone imine (NAPQI)

use N-acetylcystine (NAC) as tx, restores glutathione for reducing the toxic metabolite
Max daily dose of acetaminophen?
4 g
dose of NAC for tylenol OD

remember 150 mg/kg is the lethal dose so these go together
Why can you not give phenytoin quickly?
propylene glycol is in the mixture of phenytoin and can cause cardiovascular collapse

this is the reason for slow drip!