Remedy Trivia Quiz

Answer: N-acetylcysteine

This commonly used drug doesn't usually cause toxicity but very high doses or frequent uses can cause problems. N-acetylcysteine is the antidote most commonly used for paracetamol poisoning. The most common symptoms of this toxicity is nausea and vomiting. Without treatment, liver failure can ensue along with kidney damage and hypoglycemia. N-acetylcysteine can be given orally or intravenously and it should be started as soon as possible in a patient with paracetamol poisoning.

Answer: Deferoxamine

Elemental iron in very high doses can be toxic and cause shock and failure of multiple organs. The concentration of iron in the blood must be measured continuously during treatment of iron toxicity. Deferoxamine is a chelating agent that binds to iron and ensures its excretion from the body. During treatment with this agent, a patient's urine may turn reddish-brown, indicating that iron is being excreted in the form of a complex formed with deferoxamine.

Answer: 100% or hyperbaric oxygen

Carbon monoxide (CO) is a toxic compound that can cause severe damage to the body as it competes with oxygen in binding to hemoglobin. It has almost 200 times the affinity for hemoglobin than oxygen which makes it extremely dangerous. CO poisoning can cause symptoms varying from headache, arrhyhthmias and vision changes to coma.

It can also damage the liver. Administration of 100% oxygen is the treatment of choice for CO poisoning as inspired oxygen is not enough to challenge CO for hemoglobin and it must be given promptly, at least within six hours of CO inhalation.

Answer: Fomepizole

Toxicity of methanol or other alcohols must be treated with fomepizole. Methanol is commonly found in household solvents and can be ingested accidentally. The severe complications of this are blindness, seizures and coma. Respiratory depression is also a common symptom of alcohol poisoning. Fomepizole is an inhibitor of the enzyme alcohol dehydrogenase which prevents the metabolism of methanol. Ethanol can also be used as an agent for treatment in cases of methanol poisoning. Folic acid supplementation and hemodialysis may also be needed depending upon the level of methanol in the blood.

Answer: Naloxone

Morphine is an opioid drug that is commonly used in treating severe pain and high doses can cause toxicity, as with other opioids like meperidine. Patients with opioid toxicity can present with respiratory depression, sedation, hypotension and seizures. Alongside the usage of the specific antidote naloxone, ventilation and airway control must be ensured for the patient. Naloxone is given intravenously and it may be needed to be given in multiple doses if the toxicity is due to long acting opioids.

Answer: Hydroxocobalamin

Cyanide is a very toxic compound and its accidental poisoning is usually a result of fires in factories and chemical laboratories. Symptoms of cyanide poisoning include breathlessness, confusion, hyperventilation, seizures and it ultimately leads to death. Hydroxocobalamin is a relatively new antidote for this and is given intravenously.

Its efficiency can be enhanced if sodium thiosulfate is given along with it but through a different intravenous line. Sodium nitrite is another antidote used in cyanide poisoning as is inhaled amyl nitrite.

Answer: Dimercaprol

Mercury poisoning can occur from broken thermometers or in factories or other industrial premises. Inorganic mercury can cause vomiting, diarrhea, abdominal pain and renal failure when ingested. If inhaled, it can cause respiratory failure. Treatment of mercury toxicity usually begins with securing the patient's airway, breathing and circulation. If it was ingested, then activated charcoal with gastric lavage can be done. Dimercaprol is usually given for elemental or inorganic mercury poisoning while organic mercury poisoning is usually treated with succimer. Dimercaprol is administered intramuscularly, i.e. injected into the muscles.

Answer: Atropine

Organophosphorus compounds include pesticides and insecticides like maalthion, chlorpyrofos and parathion. This toxicity can be caused by inhaling or ingesting the compounds and also through skin contact. Physical manifestations of this poisoning include increased salivation and urination, increased heart rate and difficulty breathing.

It can also cause muscle weakness ultimately resulting in paralysis. The mainstay of treatment of this poisoning in administration of atropine which counteracts the effects of these compounds and it is given intravenously. Pralidoxime is also a drug that is used in this type of toxicity.

Answer: Digoxin-specific antibody fragments (Fab)

Digitalis glycosides like digoxin are used in treatment of heart conditions such as congestive cardiac failure. Chronic usage of this drug during therapy or accidental overdose can cause toxicity. Clinical manifestations include dizziness, confusion, coma, delirium, diarrhea and fatigue. Dosage of digoxin-specific antibody fragments must be decided while tending to the patient and kept ready for administration.

This toxicity can cause increase in potassium, called hyperkalemia, and reduction in magnesium, called hypomagnesemia, which also must be treated simultaneously.

Answer: Flumazenil

Usually benzodiazepines have a high threshold for poisoning and do not result in a high mortality rate in toxic doses. When mixed with other drugs, alcohol or in very high doses, they can be toxic. Some manifestations of diazepam (benzodiazepine) poisoning are slurred speech, sedation and decrease in intellectual function.

Induction of vomiting is not advised when this drug is ingested in toxic doses. Activated charcoal can be given to bind the drug in the stomach. Flumazenil is given intravenously and it counteracts the central nervous system effects of benzodiazepines.