Overdose And Exposure Management - NAPLEX
Card 1 of 25
Which antidote is used for acetaminophen overdose to prevent hepatic injury?
Which antidote is used for acetaminophen overdose to prevent hepatic injury?
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N-acetylcysteine (NAC). Replenishes glutathione to neutralize the hepatotoxic metabolite NAPQI in acetaminophen overdose.
N-acetylcysteine (NAC). Replenishes glutathione to neutralize the hepatotoxic metabolite NAPQI in acetaminophen overdose.
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Which antidote is used for heparin-induced bleeding or excessive anticoagulation?
Which antidote is used for heparin-induced bleeding or excessive anticoagulation?
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Protamine sulfate. Forms stable complexes with heparin to neutralize its anticoagulant effects and stop bleeding.
Protamine sulfate. Forms stable complexes with heparin to neutralize its anticoagulant effects and stop bleeding.
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What adjunct antidote reactivates acetylcholinesterase in organophosphate poisoning?
What adjunct antidote reactivates acetylcholinesterase in organophosphate poisoning?
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Pralidoxime (2-PAM). Regenerates inhibited acetylcholinesterase by cleaving the organophosphate-enzyme bond.
Pralidoxime (2-PAM). Regenerates inhibited acetylcholinesterase by cleaving the organophosphate-enzyme bond.
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Which antidote is used for life-threatening bleeding from apixaban or rivaroxaban?
Which antidote is used for life-threatening bleeding from apixaban or rivaroxaban?
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Andexanet alfa. Serves as a decoy target for factor Xa inhibitors to restore normal hemostasis.
Andexanet alfa. Serves as a decoy target for factor Xa inhibitors to restore normal hemostasis.
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What is a major risk of flumazenil in chronic benzodiazepine users or mixed overdoses?
What is a major risk of flumazenil in chronic benzodiazepine users or mixed overdoses?
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Seizures. Precipitates withdrawal in dependent users or unmasks convulsant effects in polydrug overdoses.
Seizures. Precipitates withdrawal in dependent users or unmasks convulsant effects in polydrug overdoses.
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Which antidote treats methemoglobinemia from oxidizing agents when symptomatic?
Which antidote treats methemoglobinemia from oxidizing agents when symptomatic?
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Methylene blue. Accelerates methemoglobin reduction to hemoglobin via the NADPH-methemoglobin reductase pathway.
Methylene blue. Accelerates methemoglobin reduction to hemoglobin via the NADPH-methemoglobin reductase pathway.
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Which antidote is used for hypoglycemia caused by insulin or sulfonylurea exposure?
Which antidote is used for hypoglycemia caused by insulin or sulfonylurea exposure?
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Dextrose. Provides immediate glucose to correct severe hypoglycemia from excessive insulin or sulfonylurea action.
Dextrose. Provides immediate glucose to correct severe hypoglycemia from excessive insulin or sulfonylurea action.
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Which antidote is first-line for organophosphate or carbamate poisoning with cholinergic symptoms?
Which antidote is first-line for organophosphate or carbamate poisoning with cholinergic symptoms?
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Atropine. Blocks muscarinic receptors to counteract excessive cholinergic activity from cholinesterase inhibition.
Atropine. Blocks muscarinic receptors to counteract excessive cholinergic activity from cholinesterase inhibition.
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Which medication is used to prevent recurrent hypoglycemia after sulfonylurea overdose?
Which medication is used to prevent recurrent hypoglycemia after sulfonylurea overdose?
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Octreotide. Suppresses insulin release from beta cells to mitigate prolonged hypoglycemic effects of sulfonylureas.
Octreotide. Suppresses insulin release from beta cells to mitigate prolonged hypoglycemic effects of sulfonylureas.
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Which antidote is used for symptomatic beta-blocker overdose with bradycardia or hypotension?
Which antidote is used for symptomatic beta-blocker overdose with bradycardia or hypotension?
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Glucagon. Stimulates cardiac adenylate cyclase independently of beta-receptors to improve hemodynamics.
Glucagon. Stimulates cardiac adenylate cyclase independently of beta-receptors to improve hemodynamics.
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Which therapy is recommended for refractory beta-blocker or calcium channel blocker overdose?
Which therapy is recommended for refractory beta-blocker or calcium channel blocker overdose?
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High-dose insulin euglycemia therapy (HIE). Enhances myocardial carbohydrate metabolism to provide inotropic support in refractory poisoning.
High-dose insulin euglycemia therapy (HIE). Enhances myocardial carbohydrate metabolism to provide inotropic support in refractory poisoning.
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Which antidote is used for calcium channel blocker overdose to improve hypotension?
Which antidote is used for calcium channel blocker overdose to improve hypotension?
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Calcium salts (calcium chloride or calcium gluconate). Overcomes channel blockade by increasing extracellular calcium to stabilize cardiac membranes.
Calcium salts (calcium chloride or calcium gluconate). Overcomes channel blockade by increasing extracellular calcium to stabilize cardiac membranes.
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What is the primary role of activated charcoal in overdose management when appropriate?
What is the primary role of activated charcoal in overdose management when appropriate?
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Adsorb drug in GI tract to reduce absorption. Binds toxins in the gastrointestinal lumen to limit systemic absorption and enhance fecal excretion.
Adsorb drug in GI tract to reduce absorption. Binds toxins in the gastrointestinal lumen to limit systemic absorption and enhance fecal excretion.
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What is the preferred initial decontamination method for corrosive (acid/alkali) ingestion?
What is the preferred initial decontamination method for corrosive (acid/alkali) ingestion?
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No GI decontamination; supportive care and urgent evaluation. Prevents further tissue injury by avoiding emesis or lavage that could exacerbate corrosive damage.
No GI decontamination; supportive care and urgent evaluation. Prevents further tissue injury by avoiding emesis or lavage that could exacerbate corrosive damage.
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Which agent is used for iron overdose to bind free iron and enhance elimination?
Which agent is used for iron overdose to bind free iron and enhance elimination?
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Deferoxamine. Chelates excess serum iron to form ferrioxamine, facilitating renal elimination and reducing toxicity.
Deferoxamine. Chelates excess serum iron to form ferrioxamine, facilitating renal elimination and reducing toxicity.
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Which antidote is used for cyanide poisoning from smoke inhalation or industrial exposure?
Which antidote is used for cyanide poisoning from smoke inhalation or industrial exposure?
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Hydroxocobalamin. Chelates cyanide ions to form nontoxic cyanocobalamin for urinary excretion.
Hydroxocobalamin. Chelates cyanide ions to form nontoxic cyanocobalamin for urinary excretion.
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What complication can occur after naloxone in opioid-dependent patients?
What complication can occur after naloxone in opioid-dependent patients?
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Acute opioid withdrawal. Rapid opioid receptor displacement in dependent individuals precipitates symptoms like agitation and vomiting.
Acute opioid withdrawal. Rapid opioid receptor displacement in dependent individuals precipitates symptoms like agitation and vomiting.
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What is the key lab value used to assess acetaminophen overdose severity and guide NAC need?
What is the key lab value used to assess acetaminophen overdose severity and guide NAC need?
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Serum acetaminophen concentration with time since ingestion. Plotted on the Rumack-Matthew nomogram to predict hepatotoxicity risk and determine treatment necessity.
Serum acetaminophen concentration with time since ingestion. Plotted on the Rumack-Matthew nomogram to predict hepatotoxicity risk and determine treatment necessity.
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Which antidote is used for benzodiazepine overdose when reversal is clearly indicated?
Which antidote is used for benzodiazepine overdose when reversal is clearly indicated?
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Flumazenil. Acts as a competitive antagonist at GABA_A receptors to reverse benzodiazepine-induced sedation.
Flumazenil. Acts as a competitive antagonist at GABA_A receptors to reverse benzodiazepine-induced sedation.
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What is the first-line antidote for suspected opioid overdose with respiratory depression?
What is the first-line antidote for suspected opioid overdose with respiratory depression?
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Naloxone. Competitively antagonizes mu-opioid receptors to rapidly reverse respiratory depression in opioid toxicity.
Naloxone. Competitively antagonizes mu-opioid receptors to rapidly reverse respiratory depression in opioid toxicity.
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Which antidote reverses warfarin anticoagulation in major bleeding or urgent procedures?
Which antidote reverses warfarin anticoagulation in major bleeding or urgent procedures?
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4-factor PCC plus vitamin K. PCC rapidly replenishes clotting factors, while vitamin K sustains long-term reversal of warfarin.
4-factor PCC plus vitamin K. PCC rapidly replenishes clotting factors, while vitamin K sustains long-term reversal of warfarin.
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What is the goal of naloxone titration in opioid overdose management?
What is the goal of naloxone titration in opioid overdose management?
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Restore adequate ventilation, not full arousal. Prioritizes reversing life-threatening respiratory depression while avoiding precipitation of severe withdrawal.
Restore adequate ventilation, not full arousal. Prioritizes reversing life-threatening respiratory depression while avoiding precipitation of severe withdrawal.
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Which antidote is used for life-threatening bleeding from dabigatran?
Which antidote is used for life-threatening bleeding from dabigatran?
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Idarucizumab. Specifically binds dabigatran as a monoclonal antibody to neutralize its anticoagulant activity.
Idarucizumab. Specifically binds dabigatran as a monoclonal antibody to neutralize its anticoagulant activity.
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What is the preferred initial naloxone route for a layperson in the community setting?
What is the preferred initial naloxone route for a layperson in the community setting?
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Intranasal naloxone. Offers rapid absorption and user-friendly administration without needles, ideal for non-professionals.
Intranasal naloxone. Offers rapid absorption and user-friendly administration without needles, ideal for non-professionals.
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Which antidote is used for digoxin toxicity with life-threatening arrhythmias or hyperkalemia?
Which antidote is used for digoxin toxicity with life-threatening arrhythmias or hyperkalemia?
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Digoxin immune Fab. Binds free digoxin to form complexes that are rapidly excreted, reversing cardiac toxicity.
Digoxin immune Fab. Binds free digoxin to form complexes that are rapidly excreted, reversing cardiac toxicity.
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