EMQs in Clinical Medicine.pdf - Peshawar Medical College

Treatment of poisioning and overdose 219
90 Treatment of poisoning and overdose
A
B
C
D
E
F
flumazenil
desferrioxamine
N-acetylcysteine
naloxone
dimercaprol
hyperbaric oxygen
G
H
I
J
K
L
dicobalt edetate
atropine
atenolol
intravenous fluids
vitamin K
metoclopramide paracetamol
Choose the most appropriate pharmacological management for each of the
presentations of poisoning/overdose below. Each option may be used only once.
1 A 40-year-old drowsy woman is brought to A&E with headache and vomiting
with flushed cherry-pink skin. Carboxyhaemoglobin (COHb) is 40 per cent.
2 A 20-year-old woman presents to A&E with confusion, sweating and blurred
vision after taking some ecstasy. She has a rectal temperature of 40.5°C. Creatine
kinase is 4000 U/l.
3 A 32-year-old woman presents 6 hours after a paracetamol overdose. The paracetamol
level is above the treatment line.
4 A 7-year-old boy presents to A&E with constricted pupils, sweating and
increased salivation after drinking a bottle of insecticide lying in the garden.
5 A 54-year-old painter requires treatment for lead poisoning.
Answers: see page 234.