Quiz

Quiz : What’s the antidote ?

Overdoses – Intentional, accidental including accidentally in the hospital – are common. A knowledge of antidotes to common overdoses is never wasted. This quiz might help refresh some …

Results

Perfection !!

What’s the antidote to failure ? We call it ‘TryAgainomycin”

#1. Hypermagnesemia (High blood Mg. levels)

IV Calcium Gluconate (Via Peripheral IV ) or IV Calcium Chloride (via Central line ) immediately if toxic levels of Magnesium in blood happen !

Charcoal is of no use once things are already absorbed

#2. Librium Overdose & Toxicity (Sedation)

Librium is Chlordiazapoxide is a Benzodiazepine like Diazepam (Valium) and Lorazepam (Ativan). In a intentional,  accidentaly or iatrogenic overdose if a person gets dangerously sedated IV Flumazenil (Romazicon ). However, if a person is chronically on that medication or another Benzodiazepine, or with prior seizure history – there is a high risk of withdrawals and seizures on a quick reversal like that. In this scenario, always talk to a pharmacist and Poison Control center before.

#3. Ethylene Glycol (Antifreeze)

IV Fomipazole is the drug of choice ! Other option is Ethanol but needs ICU monitoring while doing that.

#4. Oxycodone

Oxycodone is a powerful opioid, other Opiods like Fentany and Morphine will only make Oxycodone toxicity worse. The way to reverse any narcotic or opioid toxicity is Naltrexone  (Narcan) . Use the small dose possible and repeat doses till effect achieved. These days a Narcan nasal spray is available at pharmacies while the police are increasingly encouraged to carry such sprays.

#5. Acetaminophen (Tylenol)

In Tylenol poisoning, the damage is done NOT by Tylenol but it’s toxic metabolite called NAPQI, which is usually neutralized by Glutathione present in liver.  Glutathione stores get rapidly depleted in Tylenol overdose.

IV or oral N-Acetylcysteine (NAC) metabolizes to replenish Glutathione levels which in turn neutralizes NAPQI.

Is Tylenol ok in Cirrhosis ? 

Interesting a large number of people were taking NAC on a regular basis as a supplement to boost their natural Glutoathione levels for ‘longetivity’/. FDA classified NAC as a drug and not a supplement, Amazon had to pull NAC containing products from it’s website in 2021 . However this has fallen in controversial waters now that supplement enthusiasts are fighting back , Natural Products Association has sued FDA and the fight is ongoing

#6. Carbon Monoxide (CO)

Carbon Monoxide (CO) kills by replacing Oxygen molecultes carried on our Hemoglobin molecules in the blood & quickly suffocating tissues. So using a higher concentration of Oxygen is given to such patients to do a reverse Uno card and displace back all that CO by Oxygen molecules.

For mild CO poisoning, merely getting to fresh air away from the toxic source could be good enough.

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