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Overdose

Updated : January 23, 2023





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

cyclopentolate 

Management of Overdose   :

Eye: Wash your eyes with water 

Consumption: Lavage and emesis 

ADRs with severe systemic effects: Physostigmine 



activated charcoal 

1g/kg,25-100g orally

Multiple-dose regimen:
25g orally every 2 hours or 50g orally every 4 hours without sorbitol



ipecac syrup 

Not recommended for poisoning now
Presently, the medication of choice is activated charcoal
15-30 ml orally once
Repeat with 15 ml once again if emesis doesn’t occur within 20-30 minutes
Gastric lavage should be performed if vomiting doesn’t occur 30-45 minutes later the second dose
Intake of the syrup with 3-4 glasses of water



calcium chloride 

Indicated for overdose of calcium Channel Blocker
1-2 gm infused intravenously for 10-20 minutes
Repeat every 20 minutes as required for upto 5 doses



calcium chloride 

Indicated for an overdose of Beta-blocker
1000 mg bolus intravenously through a central line



nalmefene intranasal 

Indicated for Opioid overdose:


As soon as possible, administer one spray (2.7 mg) intranasally into the nose.
If the patient does not respond or respiratory depression recurs after an initial reaction, provide extra doses using a fresh nasal spray.
Administer again in 2-5 minutes if necessary until medical help arrives.



Dose Adjustments

Dosage adjustment of partial agonist or a mixed agonist/antagonist
Partial agonists or mixed agonist/antagonist drugs (such as buprenorphine or pentazocine) may only partially reverse respiratory depression, necessitating repeated intranasal administration of nalmefene.

 

cyclopentolate 

Management of Overdose   :



Eye: Wash your eyes with water 

Consumption: Lavage and emesis 

ADRs with severe systemic effects: Physostigmine 



activated charcoal 

Indicated for poisoning:


Aqueous solution
Infants- 1g/kg/dose orally. Repeat every 4-6hours
Children- 1g/kg/dose orally. Repeat every 4-6hours
Adults- 50-100gdose orally. Repeat every 4-6hours

Sorbitol suspension
Infants and children-Not indicated
Adults-50g orally as a single dose



ipecac syrup 

Not recommended for childhood poisoning now
Presently, the medication of choice is activated charcoal
For 6-12 months- 5-10 ml once with half or one cup of water under medical supervision
For 1-12 years- 15 ml orally once with 1-2 glasses of water
Repeat with 15 ml once again if emesis doesn’t occur within 20-30 minutes
For more than 12 years- 15-30 ml orally once with 3-4 glasses of water
Repeat with 15 ml once again if emesis doesn’t occur within 20-30 minutes
Gastric lavage should be performed if vomiting doesn’t occur 30-45 minutes later the second dose
Intake of the syrup with 3-4 glasses of water



nalmefene intranasal 

Indicated for Opioid overdose:

<12 years: Safety and efficacy not established
>12 years:
As soon as possible, administer one spray (2.7 mg) intranasally into the nose.
If the patient does not respond or respiratory depression returns after an initial reaction, provide extra doses using a fresh nasal spray.
Administer again in 2-5 minutes if necessary until medical help arrives.



Dose Adjustments

Dosage adjustment of partial agonist or a mixed agonist/antagonist
Partial agonists or mixed agonist/antagonist drugs (such as buprenorphine or pentazocine) may only partially reverse respiratory depression, necessitating repeated intranasal administration of nalmefene.

 

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References

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Overdose

Updated : January 23, 2023




cyclopentolate 

Management of Overdose   :

Eye: Wash your eyes with water 

Consumption: Lavage and emesis 

ADRs with severe systemic effects: Physostigmine 



activated charcoal 

1g/kg,25-100g orally

Multiple-dose regimen:
25g orally every 2 hours or 50g orally every 4 hours without sorbitol



ipecac syrup 

Not recommended for poisoning now
Presently, the medication of choice is activated charcoal
15-30 ml orally once
Repeat with 15 ml once again if emesis doesn’t occur within 20-30 minutes
Gastric lavage should be performed if vomiting doesn’t occur 30-45 minutes later the second dose
Intake of the syrup with 3-4 glasses of water



calcium chloride 

Indicated for overdose of calcium Channel Blocker
1-2 gm infused intravenously for 10-20 minutes
Repeat every 20 minutes as required for upto 5 doses



calcium chloride 

Indicated for an overdose of Beta-blocker
1000 mg bolus intravenously through a central line



nalmefene intranasal 

Indicated for Opioid overdose:


As soon as possible, administer one spray (2.7 mg) intranasally into the nose.
If the patient does not respond or respiratory depression recurs after an initial reaction, provide extra doses using a fresh nasal spray.
Administer again in 2-5 minutes if necessary until medical help arrives.



Dose Adjustments

Dosage adjustment of partial agonist or a mixed agonist/antagonist
Partial agonists or mixed agonist/antagonist drugs (such as buprenorphine or pentazocine) may only partially reverse respiratory depression, necessitating repeated intranasal administration of nalmefene.

cyclopentolate 

Management of Overdose   :



Eye: Wash your eyes with water 

Consumption: Lavage and emesis 

ADRs with severe systemic effects: Physostigmine 



activated charcoal 

Indicated for poisoning:


Aqueous solution
Infants- 1g/kg/dose orally. Repeat every 4-6hours
Children- 1g/kg/dose orally. Repeat every 4-6hours
Adults- 50-100gdose orally. Repeat every 4-6hours

Sorbitol suspension
Infants and children-Not indicated
Adults-50g orally as a single dose



ipecac syrup 

Not recommended for childhood poisoning now
Presently, the medication of choice is activated charcoal
For 6-12 months- 5-10 ml once with half or one cup of water under medical supervision
For 1-12 years- 15 ml orally once with 1-2 glasses of water
Repeat with 15 ml once again if emesis doesn’t occur within 20-30 minutes
For more than 12 years- 15-30 ml orally once with 3-4 glasses of water
Repeat with 15 ml once again if emesis doesn’t occur within 20-30 minutes
Gastric lavage should be performed if vomiting doesn’t occur 30-45 minutes later the second dose
Intake of the syrup with 3-4 glasses of water



nalmefene intranasal 

Indicated for Opioid overdose:

<12 years: Safety and efficacy not established
>12 years:
As soon as possible, administer one spray (2.7 mg) intranasally into the nose.
If the patient does not respond or respiratory depression returns after an initial reaction, provide extra doses using a fresh nasal spray.
Administer again in 2-5 minutes if necessary until medical help arrives.



Dose Adjustments

Dosage adjustment of partial agonist or a mixed agonist/antagonist
Partial agonists or mixed agonist/antagonist drugs (such as buprenorphine or pentazocine) may only partially reverse respiratory depression, necessitating repeated intranasal administration of nalmefene.

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