Emergency Medicine Flashcards
Activated charcoal dose and when to administer
1g/kg for only one dose. (Multiple dose may be considered if patient ingested in some situations). Give within one hour of ingesting overdosed drugs.
Activated charcoal contraindication
when the airway is unprotected. Intestinal obstruction decreased peristalsis, GI tract is not intact.
Acetaminophen 4 phases
Phase 1: (1-24 hours): asymptomatic or non-specific symptoms, such as N/V
Phase 2: (24-48 hours): lab signs of hepatotoxicity. Usually symptoms from phase 1 subside.
Phase 3 (48-96 hours): hepatic failure
Phase 4 (> 96hours): the patient recovers or receives a liver transplant
N-Acetylcysteine (NAC) dose for Tylenol overdose
Oral (Cetylev): 140mg/kg x 1 followed by 70mg/kg every 4 hours x 17 additional doses.
IV (Acetadote IV): 150mg/kg IV over 60 minutes, followed by 50mg/kg IV over 4 hours, followed by 100mg/kg IV over 16 hours.
Anticholinergics overdose symptoms and treatment
Red as a beet (flushing), Dry as bone (dry skin), Blind as a bat (mydriasis, double/blurry vision), Mad as a hatter (AMS, Hot as a hare (fever).
Treatment: Supportive care. Rarely use physostigmine
Warfarin overdose treatment
Phytonadione, Kcentra
Factor Xa inhibitors overdose treatment
Kcentra, Andexxa (Andexxa is only for apixaban and rivaroxaban)
Heparin/LMWH overdose treatment
Protamine
Direct thrombin inhibitor overdose treatment
Idarucizumab
What is phytonadione
vitamin K
Benzodiazepine overdose treatment
Flumazenil
Beta-blocker overdose
Glucagon (if unresponsive to symptomatic treatment), high dose insulin with glucose if glucagon doesn’t work. Lipid emulsion to increase excretion of lipophilic drugs.
CCB overdose treatment
Glucagon, insulin, lipid emulsion, or IV calcium (chloride or gluconate)
Cyanide poisoning treatment
hydroxocobalamin or sodium thiosulfate + sodium nitrite
Digoxin overdose treatment
Digoxin immune Fab (DigiFab)
