Toxins
Antidote for Cocaine induced sympathomimetic syndrome
Benzodiazepines (Clonidine also acceptable)
(Phentolamine for myocardial ischemia, sodium bicarbonate or lidocaine for ventricular dyssrythmias)
N-acetylcysteine
Acetaminophen
Bradycardia, hypotension, hypoglycemia.
beta blocker
Whole bowel irrigation
somnolent, miosis, respiratory rate 10.
naloxone
Antidotes for calcium channel blocker toxicity
Calcium
high dose insulin
Oxygen
Carbon monoxide
20 year old male with agitation, noted to be "picking at things in the air." His heart rate is 120 with blood pressure 145/90. Pupils are dilated and skin is dry and flushed.
Coricidin - acetaminophen/chlorpheniramine. (benadryl, hydroxyzine would also be acceptable)
Metformin toxicity causes severe lactic acidosis and tends to be responsive to this enhanced elimination technique
Hemodialysis
56 year old white male went to the barn to "work on the tractor." When he returned, he appeared intoxicated. pH is 7.02 with an anion gap metabolic acidosis on CMP and an osmolar gap of 35.
Fomepizole
Most concerning toxicity of Wellbutrin
Seizure
1U/kg Insulin infusion
Beta blocker (calcium channel blocker also acceptable)
64 year old female with history of congestive heart failure is found with pills around her bed. On ekg patient is found to have frequent pvc's and her initial whole blood potassium is 6.0.
Digoxin
carbamazepine, phenobarbital, theophylline, salicylates, and tricyclic antidepressants may all be indications for this enhanced elimination technique
multi-dose activated charcoal
25 year old female with an unknown ingestion. She demonstrates altered mental status. Vs: p 110 bp 130/80 r 24 sao2 95% on ra. ABG: 7.44/26/113/18
Sodium Bicarbonate
Antidote for seizures related to isoniazid
pyridoxine
cyproheptadine +/- olanzapine
serotonin syndrome
25 year old female with depression presents with 3 hours of wildly uncontrollable behavior. VS: P=124 BP = 152/110 T=39.5 R=22 SaO2=95% on RA. Pt.'s friend reports that they went clubbing and she suspects her friend may have used something. Physical exam reveals hyperreflexia, inducible clonus, and ocular clonus.
PCP (cocaine also acceptable)
This enhanced elimination technique is used in mild to moderate severity salicylate toxicity
Urinary alkalization
syncope after involvement in a structure fire. Lactate 10.
hydroxylcobalamine (amyl nitrate and sodium thiosulfate also acceptable)
Antidote for valproic acid toxicity
L-carnitine
Atropine/Pralidoxime
Organophosphate
16 year old amish female presents with generalized weakness, mild confusion, dyspnea, and a bluish tint to the lips and skin. Pulse oximetry reveals an oxygen saturation of 85%.
Nitrates in well water causing methemoglobinemia
30 year old male presents to ED, vs: p 130, bp 85/50, r 20, sao2 95% on ra. On exam, pupils are dilated, skin is dry, and patient has hypoactive bowel sounds. ECG shows wide complex tachycardia at a rate of 110.
Sodium Bicarbonate