Management of Ephedrine Overdosage PDF

Management of ephedrine overdosage Prof. Kannan Sridharan Department of Pharmacology & Therapeutics, CMHS, AGU. General management of poisoning ABCDEf  Management of ephedrine overdosage Gastric lavage Activated charcoal...

Management of ephedrine overdosage Prof. Kannan Sridharan Department of Pharmacology & Therapeutics, CMHS, AGU. General management of poisoning ABCDEf  Management of ephedrine overdosage Gastric lavage Activated charcoal Adsorption Absorption In Ephedrine overdosage, Labetalol – Preferred. Esmolol can be an alternative. Principles of management of organophosphate poisoning Organophosphate compounds toXIL was used to treat glacuna Ecothiophate Pesticide Parathion Pesticide Malathion Tabun Sarin Soman OP Clinical features of organophosphate poisoning Muscurinic Dumbels Nicotinic days of the week Dumbels Muscarinic receptor mediated Nicotinic receptor mediated Diarrhea Mydriasis they are common to Parasympathetic rapid Sympathetic breathing Urination Tachypnea effect Miosis Weakness Bradycardia, Bronchospasm Tachycardia muscle Switch Emesis Fasciculations Lacrimation stears mon thes Salivation wed thurs friday Principles of management of organophosphate poisoning management Airway ABCD Breathing Circulation Decontamination/Drugs ❑ Measures to prevent/reduce absorption (Transdermal/Oral ingestion) ❑ Anti-muscarinic drug ❑ Cholinesterase re-activators  Measures for reducing the absorption Wash skin, eyes and hair with soap & water Remove contaminated clothing Gastric lavage Activated charcoal Adsorption Anti-cholinergic drug Santagonist of muscurinic receptor Atropine sulphate – 2 to 3 mg IV stat and monitor every 10-15 minutes.  Cholinesterase reactivators par Pralidoxime sproduces Actase more - f OP OP Immediate Pralidoxime should be given before the enzyme ages. delay administration is bouz when there is a , between compound Organophosphate and Achase recommended due to there will of covalent be formation bonds that are “Aging” of the enzyme Irreursible  Anti-cholinergic drug Atropine sulphate – 2 to 3 mg IV stat followed by 1-2 mg q10-15 minutes until adequate atropinisation. every 10 to 15 mins Targets – SBP > 90 mmHg; Heart 3 things should be monitored 1. heart rate. blood 2 pressure · 3 lung fields rate > 110/minute; and clear lung target (goals) blood pressure : 90 heart rate : 110 fields lung field : clear Pupils – mid position and bowel sounds just present Acetylcholine in the Central Nervous System (CNS) organophosphate compounds are highly lipophilic , so they could easily cross blood brain barrier increase ACH , In the brain. And bouz Of excess ACh will be convulsion in CNS ,there or Excitatory in the brain Seizures Ccoma In OP poisoning, Anticonvulsants: Benzodiazepines – convulsions, Lorazepam, diazepam comatose and shallow respiration Laboratory test used for monitoring…  Plasma RBC Cholinesterase Cholinesterase More accurately Synthesized by reflect the liver enzyme in the neuronal synapse Not used for OP Used for poisoning monitoring OP monitoring poisoning  Intermediate syndrome bouz theres a risk from the the drug 24 to 96 hours first Patient 4 days. have Thus to after OP exposure be 4 observed the first days four one to days When should the patient Rapid onset, severe be discharged from progression of muscle weakness hospital? Mechanical ventilation