MI Overdose

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  1. Anticholinergic Toxicity
    Amitriptyline, nortriptyline, atropine

    Volume resuscusitation

    Ativan 2 mg, repeat after 10 min to max of 8mg

    Valium PR 0.2 mg/kg

    wide QRS use TCA protocol
  2. Beta Blocker Overdose
    50 G Activated Charcoal

    Glucose level

    Atropine 0.5 mg every 3 min to max of 3 mg

    Fluid 20 ml/kg

    For seizures 2 mg Ativan up to 8 mg q 10 min

    BP < 90 Glucagon 5 mg IV repeat after 15 min

    1 amp Calcium Gluconate

    Dopamine 5-20 mcg/kg/min
  3. Opoid Overdose
    Narcan 0.4-2 mg IV q 2-3 minutes

    Narcan infusion: mix 2mg in 500 of D5W

    0.4 mg/hr = 100 ml/hr
  4. Organophosphate Poisoning
    Volume resuscitation

    Atropine 2 mg IV doubled every 5 min until secretions and bronchoconstriction resolve

    Valium 5 mg IV to prevent seizures
  5. Tricyclic Antidepressant Overdose
    50 G activated charcoal

    For hypotension without pulmonary edema 10-20 ml/kg. Levophed if no response.

    Increased QRS > 100 ms 1-2 meq/kg of Sodium Bicarbonate, consider bicarb drip

    VT resistant to bicar consider Lidocaine 1.5 mg/kg followed by maintenance drip.

    Avoid physostigmine
Card Set
MI Overdose
Overdose protocols
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