09 S P M P On Drug Overdose

SPMP on Drug Overdose Dr. S. Aswini Kumar.MD. A 45 year-old woman is brought to the Accident and Emergency department with loss of consciousness: IX. 01. Drug overdose may be suspected under following circumstances: Found unconscious Brought in a critically ill state Unexplained acute illness Psychiatric illness or epilepsy All of the above IX. 02. The following details should be recorded in every such patient: Exact date, time and place of happening Circumstances and surroundings Brought by whom with full address Any history of previous suicidal attempts All of the above IX. 03. Clinical examination should be done to assess the following: Level of consciousness & response to pain Pupils size and reaction Pulse rate and irregularities if any Blood pressure recording All of the above IX. 04. Following Investigations to be sent immediately EXCEPT: Blood for RBS, Urea, Electrolytes Urine for sugar and ketone bodies ECG with long leads Spiral CT scan of chest Stomach contents for toxicology IX. 05. All of the statements are TRUE about Induced Emesis EXCEPT: Useful in management of oral poisoning Indicated if level of consciousness reduced Conc. Magnesium sulphate is the choice Conc. Sodium chloride solution also used Repeated if no emesis in 20 minutes IX. 06. Administration of gastric lavage is contraindicated EXCEPT in: Patient is obtunded or comatose Comatose but airway is protected Patient having seizures continuously Corrosive poisoning Primary esophageal diseases IX. 07. The following method is correct in gastric lavage EXCEPT: Positioned in head down lateral decubitus Done by a hospital attendant himself Large bore rubber tube with funnel is used Aliquots of 200ml saline are given Stomach contents cleared by lowering tube IX. 08. Complications which may occur due to or following gastric lavage are: Esophageal rupture Bleeding from the GIT Tracheal intubations Stimulation of Ventricular arrhythmias All of the above IX. 09. All of the following facts are TRUE about Activated Charcoal EXCEPT: It limits absorption of virtually all substances Dose is 1 gram/kg orally or via gastric tube Always given before emesis or gastric lavage Repeat doses of 20 grams every 2 hours C/I: Paralytic Ileus, Corrosive Ingestion IX. 10. All of the following statements are TRUE about Cathartics EXCEPT: Effectiveness not well established Administered along with activated charcoal Magnesium sulphate 3-4 ml/kg is the choice Sorbitol 10% solution is alternate choice Watery diarrhea 8-10 times a day expected IX. 11. Following statement about Whole Bowel Irrigation is NOT TRUE: Useful if drug is not absorbed by charcoal Poly Ethylene Glycol Electrolyte solution Dose is 2 liter per hour by gastric tube Given till stool is free of particulate matter Effectiveness fully established IX. 12. All of the following are TRUE about Forced Diuresis EXCEPT: Useful if kidney is major route of elimination Useful in renal or cardiac failure patients Useful in over dosage of salicylates / pheno Six hour cycles of 4 pints of RL given NaHCO3 2 meq & Frusemide 40mg/cycle IX. 13. Hemo-dialysis is useful in suspected or proved: drug overdose with ,[object Object],Ethylene Glycol Lithium Salicylates All of the above IX. 14. Close monitoring is needed in all patients with suspected for: Pulse BP JVP Basal Creps Level of consciousness by Glasgow Scale Rate and type of respiration RFT, LFT and Serum Electrolytes All of the above IX. 15. All are correct Drug and Antidote combinations EXCEPT: Methyl alcohol Ethyl Alcohol Potassium CyanideSodium Nitrite NarcoticsNaloxone DigoxinVerapamil AcetaminophenN Acetyl Cysteine IX. 16. Medico-legal aspects are the following EXCEPT: Identification marks Meticulous records Accident Register Entry Death Certification Police Intimation IX. 17. Prognosis depends on the following EXCEPT: Interval between ingestion and treatment Complete removal of gastric contents Identification of the drug if possible Early administration of Antidote Monitoring of patient by the relatives

09 S P M P On Drug Overdose

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09 S P M P On Drug Overdose