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OVERDOSAGE

This article provides guidance on recognizing and managing overdoses, including careful clinical evaluation, obtaining information from family or friends, and specific toxic syndromes. It also discusses the importance of monitoring vital signs, neurological status, pupillary reactions, and abdominal findings. The article emphasizes the use of ABG, electrolytes, acid-base balance, and screening tests, such as blood and urine tests, X-rays, and ECG. Supportive care, maintenance of airway and blood pressure, and the use of Naloxone, 50% dextrose, and thiamine for CNS depression and arrhythmias are also explained. Preventive measures like gastric emptying using activated charcoal and forced alkaline diuresis are discussed. The article concludes with information on extracorporeal removal of toxins, specific antidotes, and proper patient disposition.

josephnicholas
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OVERDOSAGE

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  1. OVERDOSAGE

  2. RECOGNITION. HIGH INDEX OF SUSPICION. CARFUL CLINICAL EVALUATION. INFORMATION FROM FAMILY OR FRIENDS. OBTAIN SUPPORTING MATERIALS. SPECIFIC TOXIC SYNDROMES. VITAL SIGNS, NEUROLOGIC STATUS,PUPILLARY REACTIONS ,ABDOMINAL FINDINGS AND UNUSUAL ODORS AND EXCRETA ABG, ELECTROLYTES AND ACID-BASE . SCREENING ,BLOOD AND URIN –XRAY-ECG.

  3. SUPPORTIVE CARE. MAINTAIN A PATENT AIRWAY. MAINTAIN BLOOD PRESSURE . ARRHYTHMIAS. CNS DEPRESSION –NALOXONE-50%DEXTROSE-THAIMINE.

  4. PREVENTION OF ABSORRPTION. ACTIVATED CHARCOAL. GASTRIC EMPTYING.

  5. ACTIVATED CHARCOAL. • ADSORBS MOST DRUGS,PREVENTING FURTHER ABSORBTION FROM GI. • EXCEPTIONS INCLUDE ALKALIS,ARSENIC,CYANIDE,ETHANOL,LITHIUM, AND MINERAL ACIDS. • 50-100 G INITIALY THEN 12.5 G/H UNTIL THE PATIENT CONDITION AND LABORATORY PARAMETERS IMPROVE.

  6. GASTRIC EMPTYING. • AIRWAY MUST BE PROTECTED. • IPECAC. • GASTRIC LAVAGE. • WHOLE-BOWEL IRRIGATION

  7. REMOVAL OF ABSORBED DRUGS FORCED ALKALINE DIURESIS ACHIEVING A URRINARY PH 7-9, PROMOTES EXCRETION OF DRUGS THAT ARE WEAK ACID SODIUM BICARBONATE 44-100 MEQ IN 1 LITTER OF 0.45 SALINE AT 250-500/H EXTRACORPOREAL REMOVAL OF TOXIN BY DIALYSIS OR HEMOPERFUSION.

  8. SPECIFIC ANTIDOTES

  9. DISPOSITION • OBSERVE FOR AT LEAST 4 H. • PSYCHATRIC COSULTATION.

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