Study Set Content:
Digoxin Chronic intoxication
Nausea, anorexia, abdominal pain, visual disturbances (flashing light, halos, green-yellow perceptual impairment), weakness, fatigue, sinus bradycardia, AF with slowed ventricular RR or junctional escape rhythm and ventricular arrhythmias and other types of arrhythmias
Propranolol Further() myocardial contractility and conduction and may be associated with () ✮ It can penetrate the brain and cause seizures and coma as this is () soluble ✮ (), () (convulsion, coma, respiratory arrest) ✮ ()()()
depress, ventricular tachyarrhythmias, lipid, Cardiac disturbances, CNS toxicity, Bronchospasm, hypoglycemia and hyperkalemia
Phenylephrine
hypotension, others:intracranial haemorrhage
Dexxtromethorphan Metabolizes in the liver by CYP2D6 to
dextrorphan
dextrorphan leads to
serotonin syndrome
Dextromethorphan In mild-moderate toxicity, patients may experience
N/V, euphoria, dysphoria, auditory and visual hallucination (closed eye visualization)
In severe toxicity, patients may experience
disorientation, stopar, psychosis, dissociative hallucination, seizure, and coma. They will also experience withdrawal symptoms
In chronic toxicity, patients may experience
psychosis, mania, and cognitive deterioration.
Lidocaine toxicity
System absorption will affect the CNS system and heart/cardio
Ibuprofen overdose
Mild GI upset
Iburpofen massive overdose
coma, renal failure, metabolic acidosis, and cardiorespiratory depression
Digoxin treatment
Emergency and supportive treatment ✮ Atropine , Correct K+, Mg2+, Lidocaine, phenytoin ✮ Digoxin specific Ab: Digifab
Propranolol
Emergency and supportive measure
bradycardia
Glucagon
Hypotension
Epinephrine
Phenylephrine
Emergency and supportive measures
hypertension
Phentolamine/ Nitroprusside -
arrhythmia
Esmolol/Metoprolol (selective beta-blocker) -
Dextromethorphan
Emergency and supportive measures ✮ Naloxone 0.06-0.4mg
Lidocaine
Emergency and supportive measures ✮ HD will not be effective since lidocaine is highly protein bound
