a) List an antidote (1drug specific to the agent) in the event of an
overdose with  each of the agents listed below in the table.

Benzodiazepines

Beta blockers

Cyanide

Digoxin

Heparin

Iron

Methanol, ethylene glycol

Methaemoglobinemia

Organophosphate

Opiates

Lead

Paracetamol

b) Which of the agents in the above list are not adsorbed by activated charcoal?

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College Answer

Benzodiazepines

Flumazenil

Beta blockers

Glucagon, adrenaline

Cyanide

Na thiosulfate, hydroxocobalamin;

Digoxin

Fab,

Heparin

Protamine

Iron

Desferrioxamine

Methanol, ethylene glycol

ethanol

Methaemoglobinemia

Ascorbic acid, methylene blue

Organophosphate

Atropine, pralidoxime

Opiates

Naloxone

Lead

Dimercaprol

Paracetamol

N-Acetylcysteine

b) Which of the agents in the above list are not adsorbed by activated charcoal?

Lead, alcohols, Fe, cyanide

Discussion

This question closely resembles Question 28.1 from the second paper of 2009, as well as Question 14.2 from the first paper of 2008. It has slightly different drugs in its table, but otherwise it is essentially the same.

However, it does ask about the charcoal.

Thus:

The following drugs are NOT treatable by charcoal:

  • cyanide
  • heparin
  • iron
  • methanol/ethylene glycol
  • methaemoglobin
  • lead

More on this can be found in a brief summary of ICU toxicology.