OVERDOSAGE

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OVERDOSAGE
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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.

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SUPPORTIVE CARE.

• MAINTAIN A PATENT AIRWAY.
• MAINTAIN BLOOD PRESSURE .
• ARRHYTHMIAS.
• CNS DEPRESSION NALOXONE-50DEXTROSE-THAIMINE.

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PREVENTION OF ABSORRPTION.

• ACTIVATED CHARCOAL.
• GASTRIC EMPTYING.

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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.

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GASTRIC EMPTYING.

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

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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.

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SPECIFIC ANTIDOTES
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DISPOSITION

• OBSERVE FOR AT LEAST 4 H.
• PSYCHATRIC COSULTATION.