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Agents & syndromes
Up Agents & syndromes Elimination Organ support Severity

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Beta blocker
Carbon monoxide
Cyanide
Dextropropoxyphene
Digoxin
Ethylene glycol
Gamma hydroxybutyrate
Isopropanolol
Lithium
Methaemoglobinaemia
Methanol
Paracetamol
Paraquat
Pesticides
Recreational drugs
Salicylate
Theophylline
Tricyclic anti-depressants

See side-bar

Amphetamines

  • presentation and management similar to that of cocaine intoxication

Miscellaneous

Drug Effects Charcoal Special methods to increase elimination Antidote
Phenothiazines Irritability, decreased consciousness, fits, hypotension, tachycardia, hypothermia, ECG changes, dystonic reactions yes no Anti-cholinergics for dystonic reactions
Monoamine oxidase inhibitors CNS excitation & sympathetic stimulation after latent period of 12-24h. Late stages: CNS depression & CVS collapse yes no Chlorpromazine may help to control cerebral excitement and hyperpyrexia. Dantrolene & muscle relaxant may help.
Serotonin re-uptake inhibitors Agitation, convulsions, hyperpyrexia yes no  
Ca blockers N&V, dizziness, coma, decreased BP & HR, AV block, hyperglycaemia, metabolic acidosis yes. May be useful up to 8h post ingestion of slow release prep. no Calcium gluconate for hypotension resistant to fluid resuscitation. 0.2-0.5 ml 10% solution every 15-20 min to a total of four doses. Glucagon 5-10 mg IV bolus over 1 min followed by 1-10 mg/h may decrease vasopressor requirements. Insulin 0.5 IU/kg/h with glucose to maintain euglycaemia may be useful for refractory shock

Further reading

Mokhlesi B. Adult toxicology in critical care. Part II: specific poisonings. Chest 2003;123:897-922

©Charles Gomersall, August, 2008 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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