toxicology

activated charcoal

• effective if <1 h

• 1g/kg x1

• CI: unprotected airway, intestinal/GI obstruction

APAP

<4 mg/d; NAC (within 8 h); Rumack-Matthew nomogram

• phase 1 (<24 h): as/x, n/v

• phase 2 (24-72 h): hepatotox

• phase 3 (72-96 h): fulminant hepatotox, jaundice, coagulopathy, renal failure

• phase 4 (>96 h): recover or transplant

anticholingeric

physostigmine

apixaban, rivaroxaban

dabigatran

warfarin

heparin

andexanet alpha

idarucizumab

vit K, PCC

protamine

antipsychotics

benztropine - dystonia

benzo - seizure

bicarbonate - QRS interval

benzo

flumazenil

BB

glucagon

CCB

glucagon ± IV calcium

cyanide, nitroprusside

hydroxocobalamin

digoxin

DigiFab

ethanol

thiamine

5FU, capecitabine

uridine triacetate

hydrocarbons

keep NPO d/t aspiration risk

insulin

dextrose (not if unconscious)

glucagon

isoniazid

vit b6

iron

deferoxamine

methotrexate

IV NaHCO3

leucovorin

glucarpidase

neostigmine

pyridostigmine

pralidoxime

nicotine

atropine, benzos

organophosphate, insecticide

atropine

pralidoxime

salicylate

NaHCO3

stimulant

benzo

toxic alcohol

fomepizole

TCA

NaHCO - widened QRS

benzo - agitation, seizure

vasopressor

valproic acid

topiramate hyperNH3

levocarnitine

mammal bite

rabie vaccine + immune globulin

snake bite

crotalidae polyvalent immune fab