Drug OD and Poisoning

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Author:
foxyt14
ID:
288299
Filename:
Drug OD and Poisoning
Updated:
2014-11-21 15:47:23
Tags:
Drugs Poisoning
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Description:
Test 5
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  1. Assessment for possible drug OD
    • ABC's
    • VS
    • cardiac monitor
    • neuro eval
    • skin color, temp, diaphoresis
    • psychosocial responses
    • hx of drug...amount and time since exposure
  2. Person comes in with suspected drug over dose...first test?
    rapid urine drug screen

    provide supportive care while doing this
  3. narcan=
    angry, violent, agitated
  4. If a drug doesn't show up on the drug screen what is my intervention?
    give supportive care only....cant give an antedote
  5. Supportive care=
    respiratory and cardiac support
  6. Diagnostic procedures for a person with possible OD
    • EKG
    • continuous cardiac monitoring
  7. Labs for a person with possible OD
    • CBC
    • serum electrolytes
    • serum/urine drug screen
    • alcohol level
    • ABG
  8. Essentials of care in overdose/poisoning
    • Stabilize the client
    • Identify the toxin
    • Reverse it's effects
    • Eliminate it
    • Support the client and significant other
  9. Dermal exposure=
    flush skin in decontamination room.....pepper spray affects everyone
  10. Inhalation exposure=
    • fresh air
    • patent airway
    • support respirations with HIGH flow O2
  11. Gastric lavage
    removal of toxic substance by cleaning out the stomach

    put saline in the stomach, then drain it by gravity via NG or OG tube with salem sumo or ewald...continue procedure until return contents is clear
  12. First priority in a person receiving gastric lavage is.....
    protect their airway....possible ET placement
  13. Activated charcoal
    prevents absorption by binding to the medication and inactivates them

    usually given down a tube after lavage
  14. Cathartics
    decrease time toxin is in the gut to decrease absorption
  15. Whole bowel irrigation
    Go Lytely...prevents absorption by washing toxins through the gut
  16. Hemodialysis and OD/poison
    x1 or x2 CRRT or CVVH for 5-7 days max
  17. S/S of salicylate OD
    • increased temp
    • N/V
    • Hyperventilate
  18. Phase 1 of Tylenol poisoning
    • <24 hours after
    • malaise
    • diaphoresis
    • n/v
  19. Phase II of Tylenol poisoning
    • 24-48 hours after
    • LFT's rise
    • RUQ pain
    • N/V
    • decreased UO
  20. Phase III of Tylenol poisoning
    • 72-96 hours after
    • N/V
    • jaundice
    • hypoglycemia
    • coagulopathies
    • DIC
  21. Phase IV of Tylenol poisoning
    Recovery....LFT's decrease
  22. How much Tylenol needs to be taken to have fatal hepatotoxicity?
    7.5gm
  23. Tx for Tylenol OD
    • gastric lavage then activated charcoal
    • Mucomyst 140mg/kg for 17 doses (68 hrs)
  24. What do I monitor on a person who is experiencing a Tylenol OD
    • cardiac
    • renal
    • hepatic fxn.....all for 2 weeks
  25. S/S of aspirin poisoning
    • tachypnea
    • tachycardia
    • hyperthermia
    • seizures
    • pulmonary edema
    • bleeding
    • metabolic acidosis
  26. Tx for Aspirin poisoning
    • gastric lavage and activated charcoal
    • urine alkinazation
    • hemodialysis for severe acute ingestion
    • intubation/ventilation
  27. NSAID poisoning...s/s and tx
    • gastroenteritis
    • abd pain
    • nystagmus
    • hepatic/renal damage/dysfunction

    • gastric lavage
    • activated charcoal
    • cathartics
  28. Anti depressant s/s of high dose poisoning
    • CNS depression
    • arrhythmias
    • hypotension
    • respiratory depression
  29. Tx for anti depressant poisoning
    • gastric lavage
    • activated charcoal
    • cathartics
  30. S/S of stimulant/nicotine poisoning
    • increased alertness and arousal
    • performance enhancement
    • increased HR, CO and BP
  31. S/S of stimulant/nicotine OD
    • RARE
    • n/v
    • abd pain
    • dizzy/weak/confused
    • decreased RR to respiratory failure
  32. Overdose from cocaine/amphetamines
    • agitation
    • increased temp, HR, BP, RR
    • arrhythmias
    • MI
    • hallucinations and possible death
  33. How do you treat people with Stimulant OD?
    • ensure patent airway-possible intubation
    • IV
    • 12 lead EKG
    • treat arrhythmias
    • monitor VS, LOC
    • restrain patient for pt and staff safety
  34. What treats psychosis?
    Haldol
  35. What treats seizures?
    valium or ativan
  36. What is given for concurrent opiate use?
    Narcan
  37. What is used for HTN and tachy?
    Inderal/Labetalol
  38. S/S of Depressants OD
    depressants-alcohol, barbituates, benzos

    • shallow respirations
    • cold clammy skin
    • weak rapid pulse
    • hypotension
    • hyporeflexia
    • coma/death
  39. Care for a person with depressant OD
    • be aware of potentiation with other CNS depressants and cross tolerance
    • treat for alcohol withdrawl
  40. S/S of Opioid OD
    • shallow respirations
    • clammy skin
    • constricted pupils
    • coma/possible death
  41. opioids
    • heroin
    • morphine
    • codeine
    • fentanyl
    • hydromorphone
    • oxycodone
    • methadone
  42. Collaborative care for opioid OD
    narcan is used to reverse the sedative factor of opioids and will cause withdrawl symptoms....so give methadone to decrease these symptoms
  43. S/S of marijuana OD
    • fatigue
    • paranoia
    • panic rxn
    • nallucinations
    • psychotic states
  44. S/S of Hallucinogen OD
    • anxiety
    • respiratory depression
    • cardiac arrhythmias
    • loss of consciousness
    • sudden death
  45. S/S of withdrawl of hallucinogens
    none
  46. S/s of Inhalant OD
    • anxiety
    • respiratory depression
    • arrhythmias
    • loss of consciousness
    • sudden death

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