Toxicological Emergencies and Overdose Management Flashcards

What is the first-line antidote for reversing opioid-induced respiratory depression?

Answer: Naloxone

Naloxone (Narcan) is a competitive opioid receptor antagonist and is the standard first-line treatment to reverse opioid-induced respiratory depression.

A patient presents with miosis, bradycardia, bronchospasm, and excessive secretions after unknown substance ingestion. Which toxidrome does this represent?

Answer: Cholinergic

Cholinergic toxidrome (SLUDGE/DUMBELS) presents with miosis, bradycardia, bronchospasm, and excessive secretions, typically from organophosphate or carbamate exposure.

What is the recommended initial adult IV dose of naloxone for suspected opioid overdose?

Answer: 0.4 to 2 mg

The standard initial adult IV dose of naloxone ranges from 0.4 to 2 mg, titrated to restore adequate ventilation without precipitating full withdrawal in opioid-tolerant patients.

Which combination of antidotes is used to treat severe organophosphate poisoning?

Answer: Pralidoxime (2-PAM) and atropine

Atropine reverses muscarinic effects and pralidoxime (2-PAM) reactivates acetylcholinesterase before aging occurs, making them the dual treatment for organophosphate poisoning.

A patient with tricyclic antidepressant (TCA) overdose develops a wide QRS complex and hypotension. What is the treatment of choice?

Answer: Sodium bicarbonate IV

Sodium bicarbonate alkalinizes the serum and increases the sodium gradient, narrowing the QRS complex and improving hypotension caused by TCA-induced sodium channel blockade.

What is the primary mechanism by which activated charcoal reduces toxin absorption in the GI tract?

Answer: Adsorption of toxins to prevent absorption

Activated charcoal works by adsorbing (binding) toxins in the GI tract to its large surface area, preventing their absorption into the bloodstream without altering the substance chemically.

A patient presents with hyperthermia, tachycardia, hypertension, agitation, diaphoresis, and dilated pupils after using a stimulant. Which toxidrome is this?

Answer: Sympathomimetic

Stimulants such as cocaine and amphetamines cause sympathomimetic toxidrome featuring hyperthermia, tachycardia, hypertension, agitation, diaphoresis, and mydriasis.