💓 Savvy NurseLouvri aplikasyon an

💊 Famakoloji · Leson 4 sou 6 · 6 min

Tablo Antidòt ou Pral Wè Jou Egzamen an

The Antidote Table You Will See on Exam Day

🧪 Yon surdoz acetaminophen sanble li pa danjere pandan 24 èdtan epi apre li detwi fwa a. Antidòt la mache pi byen nan premye 8 èdtan yo. Egzamen an ba ou yon delè ak yon non medikaman epi li atann ou matche yo imedyatman.

🧪 Acetaminophen overdose looks harmless for 24 hours and then destroys the liver. The antidote works best in the first 8 hours. The exam gives you a timeline and a drug name and expects an instant match.

💡 Ide prensipal

Naloxone pou opioid, flumazenil pou benzodiazepine, acetylcysteine pou acetaminophen, protamine pou heparin, vitamin K pou warfarin, calcium gluconate pou magnesium.

Naloxone for opioids, flumazenil for benzodiazepines, acetylcysteine for acetaminophen, protamine for heparin, vitamin K for warfarin, calcium gluconate for magnesium.

🧠 Poukisa sa enpòtan

OPIOID: NALOXONE, ki ka fini anvan opioid la fini, kidonk siveye epi repete. BENZODIAZEPINE: FLUMAZENIL, yo itilize li ak prekosyon paske li ka deklanche kriz lakay pasyan ki depandan yo. ACETAMINOPHEN: ACETYLCYSTEINE, ki pi efikas nan 8 èdtan; domaj nan fwa rive nan pik li a 72 a 96 èdtan. HEPARIN: PROTAMINE SULFATE. WARFARIN: VITAMIN K; DIGOXIN: digoxin immune Fab. MAGNESIUM SULFATE (pou preeklanpsi): CALCIUM GLUCONATE, yo kenbe li bò kabann lan; veye pèt reflèks tendine pwofon yo, respirasyon anba 12 ak pipi anba 30 mL/hr. FÈ: deferoxamine. TOKSISITE ANTIKOLINÈJIK (hot as a hare [cho tankou yon lapen], dry as a bone [sèk tankou yon zo], red as a beet [wouj tankou yon bètràv], mad as a hatter [fou tankou yon chapliye]): physostigmine. Kriz KOLINÈJIK, tankou twòp inibitè kolinesteraz nan myasthenia gravis (salivasyon, lakrimasyon, pipi, defekasyon, bradikadi): atropine. Anpwazonnman ORGANOPHOSPHATE: atropine plis pralidoxime. Surdoz BLOKÈ BETA: glucagon. MONOKSID KABÒN: 100% oksijèn. METHOTREXATE: leucovorin. PLON: kelasyon ak succimer oswa EDTA. CYANIDE: hydroxocobalamin. Dabigatran: idarucizumab. Pou nenpòt anpwazonnman yo sispèk, rele sant kontwòl pwazon an; pa pwovoke vomisman.

OPIOIDS: NALOXONE, which can wear off before the opioid does, so monitor and repeat. BENZODIAZEPINES: FLUMAZENIL, used cautiously because it can trigger seizures in dependent clients. ACETAMINOPHEN: ACETYLCYSTEINE, most effective within 8 hours; liver damage peaks at 72 to 96 hours. HEPARIN: PROTAMINE SULFATE. WARFARIN: VITAMIN K. DIGOXIN: digoxin immune Fab. MAGNESIUM SULFATE (for preeclampsia): CALCIUM GLUCONATE, kept at the bedside; watch for loss of deep tendon reflexes, respirations under 12 and urine output under 30 mL/hr. IRON: deferoxamine. ANTICHOLINERGIC toxicity (hot as a hare, dry as a bone, red as a beet, mad as a hatter): physostigmine. CHOLINERGIC crisis, such as cholinesterase-inhibitor excess in myasthenia gravis (salivation, lacrimation, urination, defecation, bradycardia): atropine. ORGANOPHOSPHATE poisoning: atropine plus pralidoxime. BETA-BLOCKER overdose: glucagon. CARBON MONOXIDE: 100% oxygen. METHOTREXATE: leucovorin. LEAD: chelation with succimer or EDTA. CYANIDE: hydroxocobalamin. Dabigatran: idarucizumab. For any suspected poisoning, call the poison control center; do not induce vomiting.

🏥 Nan lavi reyèl

🕗 Yon adolesan rive sis èdtan apre li vale yon boutèy acetaminophen, li santi li byen eksepte yon ti noze lejè. Anzim fwa li yo nòmal. Enfimyè a pran yon nivo acetaminophen kat èdtan oswa plis epi li prepare acetylcysteine san li pa tann sentòm yo, paske lè fwa a montre domaj, peryòd kote antidòt la pwoteje pi byen an deja pase.

🕗 A teenager arrives six hours after swallowing a bottle of acetaminophen, feeling fine except for mild nausea. Her liver enzymes are normal. The nurse draws a four-hour-plus acetaminophen level and prepares acetylcysteine without waiting for symptoms, because by the time the liver shows damage, the antidote's most protective window has passed.

📌 Sa pou retni

  • Naloxone ka bezwen repete; flumazenil ka pwovoke krizNaloxone may need repeating; flumazenil can cause seizures
  • Acetylcysteine mache pi byen nan 8 èdtan apre yon surdoz acetaminophenAcetylcysteine works best within 8 hours of acetaminophen overdose
  • Calcium gluconate bò kabann lan pou chak perfusion magnesium sulfate nan preeklanpsiCalcium gluconate at the bedside for every magnesium sulfate infusion in preeclampsia

📖 Tèm nan leson sa a

Antidòt (Antidote): Yon medikaman ki ranvèse efè yon lòt, tankou naloxone pou opioids oswa vitamin K pou warfarin.

SLUDGE (kriz kolinèjik) (SLUDGE (cholinergic crisis)): Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis (salivasyon, dlo nan je, pipi, poupou, pwoblèm GI, vomisman): siy twòp asetilkolin (anpwazònman organophosphate oswa kriz kolinèjik), atropine ranvèse yo.

Nivo acetaminophen (toksik) (Acetaminophen level (toxic)): Yon nivo pi wo pase ozanviwon 150 mcg/mL yo pran 4 èdtan apre enjestyon se toksik sou nomogram Rumack-Matthew la epi li mande acetylcysteine; anzim fwa yo souvan rive nan pik yo 2 a 4 jou apre, apre premye kè plen an fin pase.

Atropine: Antikolinerjik ki akselere yon kè ralanti sentomatik (1 mg IV, repete chak 3 a 5 minit jiska 3 mg) epi antidot pou kriz kolinerjik ak anpwazònman organophosphate; atann bouch sèk, vizyon twoub, retansyon pipi ak woujè.

Protamine ak vitamin K (Protamine and vitamin K): Pè ranvèsman antikoagulan: protamine netralize heparin nan kèk minit men pouse vit lakòz ipotansyon ak anafilaksi; vitamin K ranvèse warfarin sou plizyè èdtan, oralman oswa pa IV dousman ak PCC 4-factor pou senyen grav; absòpsyon anba po a pa regilye, epi dòz IV/IM pote yon avètisman nan bwat.

Naloxone: Antidot opioid la, bay IV, IM oswa nan nen epi repete chak 2 a 3 minit jiskaske pasyan an respire; li fini anvan pifò opioid, kidonk kontinye siveye pou sedasyon ki retounen, epi atann doulè sibit ak sentòm sevraj.

Acetaminophen: Soulajman doulè ak lafyèv ki detwi fwa a nan surdozaj pandan li sanble san danje pou premye jou a; kenbe total la anba 4 gram pa jou (mwens ak maladi fwa oswa alkòl regilye), konte pwodwi konbine yo, epi bay acetylcysteine, pi bon nan 8 èdtan.

✅ Teste tèt ou

Yon pasyan k ap resevwa magnesium sulfate IV pou preeklanpsi pa gen reflèks patelè epi batman respirasyon li se 10. Ki medikaman enfimyè a ta dwe prepare?A client receiving IV magnesium sulfate for preeclampsia has absent patellar reflexes and a respiratory rate of 10. Which medication should the nurse prepare?
  1. Naloxone
  2. Calcium gluconate
  3. Protamine sulfate
  4. Flumazenil

Repons: B · Calcium gluconate

Reflèks ki pèdi ak depresyon respiratwa se siy toksisite magnesium; calcium gluconate se antidòt la. Sispann perfusion an an premye. Naloxone ranvèse depresyon respiratwa opioid pwovoke sèlman; li pa gen efè sou magnesium, kidonk li pa ta retabli reflèks oswa respirasyon isit la.

Lost reflexes and respiratory depression are signs of magnesium toxicity; calcium gluconate is the antidote. Stop the infusion first. Naloxone reverses opioid-induced respiratory depression only; it has no effect on magnesium, so it would not restore reflexes or breathing here.

Ki antidòt yo bay pou surdoz acetaminophen?Which antidote is administered for acetaminophen overdose?
  1. Acetylcysteine
  2. Deferoxamine
  3. Glucagon
  4. Atropine

Repons: A · Acetylcysteine

Acetylcysteine ranpli glutathione epi li pwoteje fwa a, ideyalman nan 8 èdtan apre enjesyon an. Deferoxamine se antidòt toksisite fè; li mare fè epi li pa gen efè sou metabolit acetaminophen ki blese fwa a.

Acetylcysteine replenishes glutathione and protects the liver, ideally within 8 hours of ingestion. Deferoxamine is the antidote for iron toxicity; it binds iron and has no effect on the acetaminophen metabolite that injures the liver.

Apre naloxone, yon pasyan ki te fè surdoz ak yon opioid ki aji lontan reveye epi li respire nòmalman. Poukisa enfimyè a dwe kontinye siveye li deprè?After naloxone, a client who overdosed on a long-acting opioid wakes up and breathes normally. Why must the nurse continue close monitoring?
  1. Naloxone fini anvan opioid laNaloxone wears off before the opioid
  2. Yo dwe bay flumazenil apre naloxoneNaloxone must be followed by flumazenil
  3. Naloxone pwovoke domaj nan fwaNaloxone causes liver damage
  4. Pasyan an ap devlope sendwòm serotoninThe client will develop serotonin syndrome

Repons: A · Naloxone fini anvan opioid la

Dire naloxone pi kout pase anpil opioid. Sedasyon ankò ak depresyon respiratwa ka retounen, sa ki mande dòz repete. Flumazenil ranvèse benzodiazepine, pa opioid, kidonk li pa gen wòl nan surdoz opioid sa a.

Naloxone's duration is shorter than many opioids. Resedation and respiratory depression can recur, requiring repeat doses. Flumazenil reverses benzodiazepines, not opioids, so it plays no role in this opioid overdose.

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