Toxicology

    Drug/Toxin Signs/Sx and Diagnostics Management Options
    Acetaminophen Vomiting, ↑ AG & nl OG metabolic acidosis, hepatitis & hepatic failure, renal failure N-acetylcysteine (NAC) infusion
    Hemodialysis if massive O/D
    See “Acute liver failure”
    Salicylates Tinnitus, hyperventilation, abd. pain, vomiting, ΔMS,
    mixed ↑ AG & nl OG metabolic acidosis + respiratory alkalosis
    IVF resuscitation
    Alkalinization w/ NaHCO3
    Maintain respiratory alkalemia
    Consider hemodialysis
    Opioids ↓ mentation, ↓ RR, miosis IV naloxone
    Benzodiazepines ↓ mentation, ataxia, ↓ RR Flumazenil not rec (can precipitate withdrawal/seizures)
    Calcium channel blockers Bradycardia, AV block, hypotension, HF, hyperglycemia IVF, ulinemic euglycemia,