CPR Toxicological Emergencies and Overdose Management 2

Question 1

Which antidote is used for acetaminophen (Tylenol) overdose to prevent hepatotoxicity?

Accepted Answer

N-acetylcysteine (NAC)

Answer

N-acetylcysteine replenishes glutathione stores and detoxifies NAPQI, the hepatotoxic acetaminophen metabolite, preventing liver failure when administered within the treatment window.

Question 2

A patient is found unresponsive in a closed garage with altered mental status, severe headache, and cherry-red skin. What poisoning is most likely?

Accepted Answer

Carbon monoxide

Answer

Carbon monoxide binds hemoglobin with approximately 200 times the affinity of oxygen, causing tissue hypoxia; the classic cherry-red skin finding is caused by carboxyhemoglobin.

Question 3

What is the treatment for hemodynamically unstable beta-blocker overdose refractory to initial resuscitation measures?

Accepted Answer

High-dose insulin euglycemic therapy and calcium

Answer

High-dose insulin euglycemic therapy improves cardiac contractility in beta-blocker overdose by providing an alternative metabolic substrate; calcium supports hemodynamics by partially overcoming blockade.

Question 4

Which benzodiazepine reversal agent must be used with extreme caution in patients with chronic benzodiazepine use or seizure history?

Accepted Answer

Flumazenil

Answer

Flumazenil can precipitate severe withdrawal seizures in benzodiazepine-dependent patients and in those whose epilepsy is controlled by benzodiazepines, making it potentially life-threatening in these populations.

Question 5

A patient ingested methanol and presents with visual disturbances and high anion-gap metabolic acidosis. What is the antidote?

Accepted Answer

Fomepizole (4-MP)

Answer

Fomepizole inhibits alcohol dehydrogenase, preventing conversion of methanol to formic acid, the toxic metabolite responsible for metabolic acidosis and optic nerve damage.

(CPR) Certified Paramedic Response Practice Test

(CPR) Certified Paramedic Response Practice Test

CPR Toxicological Emergencies and Overdose Management 2