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Table 2.17-4 from First Aid for the USMLE Step 2 CK

Acetaminophen

N-acetylcysteine.

Acid/alkali ingestion

Upper endoscopy to evaluate for stricture.

Acetylcholinesterase inhibitors, organophosphates

Atropine, pralidoxime.

Antimuscarinic/anticholinergic agents

Physostigmine

Arsenic, mercury, gold

Succimer, dimercaprol (BAL)

Beta-blockers

Glucagon.

Barbiturates (phenobarbital)

Urine alkalinization, dialysis, activated charcoal, supportive care.

Benzodiazepines

Flumazenil.

Black widow bite

Calcium gluconate, methocarbamol.

Carbon monoxide

100% O2, hyperbaric O2.

Copper, arsenic, gold

Penicillamine.

Cyanide

Amyl nitrite, hydroxocobalamin, sodium thiosulfate.

Digitalis

Normalize K+ but avoid giving Ca++, Mg++, or lidocaine (for torsades), anti-dig Fab fragments.

Heparin

Protamine sulfate.

INH

Pyridoxine.

Iron salts

Deferoxamine.

Lead

Succimer, CaEDTA, dimercaprol.

Methanol, ethylene glycol (antifreeze)

Ethanol, fomepizole, dialysis, calcium gluconate for ethylene glycol.

Methemoglobin

Methylene blue.

Opioids

Naloxone.

Salicylates

Urine alkalinazation (NaHCO3), dialysis, activated charcoal.

TCAs

NaHCO3 (plasma alkalinization) for QRS prolongation; diazepam or lorazempam for seizures, cardiac monitor for arrhythmias.

Theophylline

Activated charcoal. Consider repeat dose.

tPA, streptokinase

Aminocaproic acid.

Warfarin

Vitamin K, fresh frozen plasma.

amphetamines (basic)

NH4Cl (acidify urine).

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