Aspirin Poisoning
Benzodiazepines
Carbon Monoxide Poisoning
Paracetamol Poisoning
Tricyclic Poisoning
General
The management of most overdoses or poisonings is supportive with the emphasis on airway, breathing and circulation. For most substances there is no effective antidote. If in doubt about how to manage a particular case discuss with senior ED Doctor or consult Toxbase. All suspected overdose patients should have paracetamol level checked, a blood glucose and an ECG.
Always consider overdose in patients whose history and physical findings are inconsistent, particularly in those whose conscious level and neurological findings change from minute to minute.
Gut decontamination
- There is no role for gastric lavage in the management of overdoses unless specifically indicated after discussion with the National Poisons Information Service (NPIS).
- There is a limited role for activated charcoal in alert patients who present within an hour of ingestion. The dose is 50g for adult or 1g/kg in a child.
Drugs bound by activated charcoal
Paracetamol
Theophylline
Benzodiazepines
Digoxin
Salicylates
Carbamazepine
Tricyclics
Phenytoin
Commonly used Antidotes
N-acetylcysteine (parvolex)...... Paracetamol
Naloxone…………………......... Opiates
Desferroximine……………....... Iron
Hydroxocobalamin(Cyanokit)....Cyanide
Ethanol……………………........ Methanol
Access to Toxbase
Username H1844 Password EEN37A