In the setting of haemodynamic collapse secondary to drug overdose, give the pharmacological antidote/s for each of the agents listed below. For each antidote cited, give the rationale/mechanism of action.
a) Digoxin.
b) Tricyclic anti-depressants.
c) Beta blockers.
d) Lignocaine.
Detail in template more than required for full marks:
Digoxin |
Digoxin Fab Fragments (Digibind) |
|
TCA |
Sodium bicarbonate |
Sodium load
|
Beta Blockers |
Glucagon |
|
High Dose insulin +/- glucose therapy |
Several theories of effect:
|
|
Atropine |
• Anti-cholinergic agent |
|
Lignocaine |
Lipid emulsion therapy |
|
This question begs for a tabulated answer. The college table is comprehensive and difficult to improve upon. One's only recourse would be either to make the answer more succinct, or (more likely) to add more unnecessary detail ("more than required for full marks").
Drug | Antidote | Rationale/mechanism |
Digoxin |
Digoxin-specific Fab fragments |
|
Tricyclics | Sodium bicarbonate |
|
β-blockers | High dose insulin with euglycaemia |
|
Glucagon |
|
|
Atropine |
|
|
Lignocaine | Lipid emulsion |
|
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