A 35 yr old chronic alcoholic on long term diazepam therapy for anxiety disorder presents to the ER accompanied by his wife who states that she found him in an altered state of consciousness with an empty bottle of diazepam at his bedside. According to the "note" he took them more than 8 hours ago.
O/E decreased alertness with coarse nystagmus, ataxia, slurred speech, and postural unsteadiness.
What is the best next step in management?
A. Flumazenil
B. Activated Charcoal
C. Ipecac syrup
D. Gastric lavage
E. Supportive measures
F. Benzodiazepines levels
G. Whole bowel lavage
H. Dialysis
I. Pray
it is extremely hard for Benzos to kill you because the toxic dose is over a thousand fold the therapeutic dose, besides if he trully took them 8 hours ago he would be dead by know which he isnt, jsut supportive measures with close attention to seizure and/or respiratory failure is all that is required, in case he develops seizures secondary to benzos withdrawal guess what.. we would give benzos to stop the seizure haha
it is extremely hard for Benzos to kill you because the toxic dose is over a thousand fold the therapeutic dose, besides if he trully took them 8 hours ago he would be dead by know which he isnt, jsut supportive measures with close attention to seizure and/or respiratory failure is all that is required, in case he develops seizures secondary to benzos withdrawal guess what.. we would give benzos to stop the seizure haha
i got a small doubt............in TCA overdose, do we wait for the ECG confirmation of prolong QRS interval or pump sodium bicarbonate as soon as we hear TCA toxicity..??????
Mm m i would give the cocktail for the coma patient; naloxone thiamine and after thiamine, dextrose
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