OVERDOSAGE RECOGNITION HIGH INDEX OF SUSPICION CARFUL CLINICAL

OVERDOSAGE

. RECOGNITION §HIGH INDEX OF SUSPICION. §CARFUL CLINICAL EVALUATION. §INFORMATION FROM FAMILY OR FRIENDS. §OBTAIN SUPPORTING MATERIALS. §SPECIFIC TOXIC SYNDROMES. §VITAL SIGNS, NEUROLOGIC STATUS, PUPILLARY REACTIONS , ABDOMINAL FINDINGS AND UNUSUAL ODORS AND EXCRETA §ABG, ELECTROLYTES AND ACID-BASE. §SCREENING , BLOOD AND URIN –XRAY-ECG.

. SUPPORTIVE CARE §MAINTAIN A PATENT AIRWAY. §MAINTAIN BLOOD PRESSURE. §ARRHYTHMIAS. §CNS DEPRESSION –NALOXONE-50%DEXTROSETHAIMINE.

. PREVENTION OF ABSORRPTION §ACTIVATED CHARCOAL. §GASTRIC EMPTYING.

. ACTIVATED CHARCOAL § § § ADSORBS MOST DRUGS, PREVENTING FURTHER ABSORBTION FROM GI. EXCEPTIONS INCLUDE ALKALIS, ARSENIC, CYANIDE, ETHANOL, LITHIUM, AND MINERAL ACIDS. 50 -100 G INITIALY THEN 12. 5 G/H UNTIL THE PATIENT CONDITION AND LABORATORY PARAMETERS IMPROVE.

. GASTRIC EMPTYING n n AIRWAY MUST BE PROTECTED. IPECAC. GASTRIC LAVAGE. WHOLE-BOWEL IRRIGATION

REMOVAL OF ABSORBED DRUGS §FORCED ALKALINE DIURESIS ACHIEVING A URRINARY PH 7 -9, PROMOTES EXCRETION OF DRUGS THAT ARE WEAK ACID §SODIUM BICARBONATE 44 -100 MEQ IN 1 LITTER OF 0. 45 SALINE AT 250 -500/H §EXTRACORPOREAL REMOVAL OF TOXIN BY DIALYSIS OR HEMOPERFUSION.

SPECIFIC ANTIDOTES

DISPOSITION n n OBSERVE FOR AT LEAST 4 H. PSYCHATRIC COSULTATION.