Poisons and antidotes.
In regards to Naloxone (Narcan) which of the following is INCORRECT?
The initial dose may be IM or IV as per answer 1 and 2. The nasal spray is available via selected pharmacies free to narcotic drug users, carers and families of users. It is a pilot program in NSW at the moment. 2 hours is the longest time I have seen quoted for observation--and this is unlikely!
Which answer is CORRECT about Digibind?
Bit tough---we used to say 5 vials IV stat but after the DORA trial you give 2 vials IV initially (Thanks Betty Chan). Digibind works rapidly in about 30min. If you read the box it says 1 vial neutralises 500mic of Digoxin.
About paracetamol poisoning which of the following is INCORRECT?
Acetaminophen is what paracetamol is called in the USA just to confuse everyone. Like trash/garbage---vacation/holiday----cab/taxi---cilandro/coriander---Tylanol/Panadol.
If you "over sedated" an elderly lady with Midazolam whilst relocating her shoulder what drug would reverse the problem and calm your sinking feeling?
Give Flumazenil 100 to 200 mic IV then titrate to response. Works well.
Why was Jade the material of choice to drink wine from?
The Ancient Greeks actually thought Amethyst--not Jade--- decreased the intoxicating effects of alcohol. Amethyst---comes from the Greek word "Amethystos" or "not drunken".
What of the following is NOT TRUE about Deferoxamine?
It certainly can be given in children. Check with Poisons info---131126 to get guidance of what 4hr serum iron level cut off they would recommend its use.
A man with MetHb after a "popper" ingestion has been given an antidote that has made his urine green. What is the antidote?
He had taken Amyl nitrate poppers ++ causing MetHb. Methylene blue acts as a cofactor for MetHb reductase.
This young man has taken a Tricyclic depressant overdose. What can you give intravenously to improve his ECG?
NaHC03 will narrow the QRS complexes and decrease the prolonged QT interval. NaHCO3 is also useful in Carbamazepine (Tegretol) and Hydroxychloroquine (Plaquenil) overdoses.
What of the following is NOT TRUE about HIET (High dose insulin euglycemic therapy).
Its main use is in Ca channel overdoses but can sometimes be used in B Blocker overdoses.
Bezoars--have for a long time been thought to work against poisons. What was the poison that the 1st Century Arabic author al-Birumi thought Bezoars worked against?
Bezoars are balls of undigested food, hair, fur or stones found in many animals. A cat fur ball is an example. I would not like to taste the snot of Satan.