Cocaine

Last Updated on February 10, 2022 by frcemuser Cocaine is associated with ischaemic chest pain, even in the young This is multifactorial, coronary vasospasm, accelerated atherosclerosis, increased platelet adhesion, increased cardiac oxygen demand. Diazepam reduces agitation, heart rate and oxygen demand Nitrates reduce spasm Give aspirin as usual Treat STEMI […]

Serotonin Syndrome

Last Updated on February 10, 2022 by frcemuser Serotonin syndrome results from drug-induced over-stimulation of serotonin receptors in the CNS and is characterized by a triad of CNS dysfunction, autonomic disturbance and neuromuscular effects.onset usually within 24hrs Drugs Antidepressants: SSRI, TCA, MAOI Analgesics: tramadol, fentanyl, dextromethorphan (in cough remedies). Antiemetics: […]

Metabolic Acidosis – Anion GAP

Last Updated on February 9, 2022 by frcemusercauses of increased anion gap metabo1ic acidosis Anion Gap (without K) = Na – (Cl + HCO3) Anion Gap (with K) = (Na + K) – (Cl + HCO3) Normal range 12-16 Methanol, metformin Uraemia Diabetic ketoacidosis Phenformin, pyroglutamic acid, paraldehyde, propylene glycol, […]

Iron Overdose

Last Updated on January 30, 2022 by frcemuseroverview Can produce peroxide and hence free radicals Free radicals can cause major intracellular damage About 10% absorbed 20-60 mg/Kg of elemental iron is mildly to moderate toxic. Toxic quantities achieved more readily in children Toxicity is greatest in gastrointestinal cells and liver […]

Toxic Alcohol Ingestion

Last Updated on January 30, 2022 by frcemuserMethanol and ethylene glycol Both can cause metabolic acidosis, and both are treated in a similar way Methanol Methanol is the simplest alcohol Contained in methylated spirits Similar smell to ethanol Converted to formic acid, which is not easily excreted by the body […]

Toxicology – Induction

Last Updated on January 29, 2022 by frcemuserGeneral Principle Reduce absorption Oral Adsorbents: activated charcoal Gastric Lavage Whole Bowel Irrigation Increase elimination Specific antidotes Treat complications as required Activated Charcoal Give within 1 hour! It May be effective after 1 hour for Tricyclics/opiates (delayed gastric emptying) , Salicylate (delayed absorption […]

Venous thromboembolic diseases – DVT / PE

Last Updated on January 28, 2022 by frcemuser  Deep Vein Thrombosis    Pulmonary Embolism     Treatment Options   Thrombolysis ((t-PA Alteplase) for massive PE 10mg iv bolus followed by 90mg iv infusion over 2 hours If cardiac arrest imminent – 50mg bolus Nice: https://www.nice.org.uk/guidance/ng158/resources/visual-summary-pdf-8709091453

NIV – Acute Hypercapnic Respiratory Failure

Last Updated on January 26, 2022 by frcemuserIndications COPD: pH < 7.35 AND PaC02 ≥ 6.5 RR > 23 despite one hour of medical management Neuromuscular Disease:  Respiratory illness with RR >20 if usual VC <1L or pH < 7.35 AND PaC02 ≥ 6.5 Obesity: pH < 7.35 AND PaC02 […]

Chronic Obstructive Pulmonary Disease

Last Updated on January 26, 2022 by frcemuser Airflow obstruction is defined as a value of <0.7 when a ratio of the FEV1 (Forced expiratory volume in 1 second) / FVC (Forced vital capacity) is measured. medical treatment  Controlled oxygen therapy to maintain SaO2 88-92% Nebulised salbutamol 2.5-5 mg Nebulised […]

Organ donation and laws – Draft

Last Updated on January 24, 2022 by frcemuserWho can become an organ donor There is no age limit for becoming an organ donor. Children who are under 12 in Scotland and under 18 in the rest of the UK at the time of registration will require their parent or guardian’s […]