You conduct a medication review on a 68-year-old man with a history of angina. He is currently prescribed 10 mg bisoprolol once daily and GTN spray as needed. However, he continues to experience symptoms.
Which ONE medication should be avoided in this patient?
A 25-year-old man presents having ingested an overdose of an unknown substance. He is drowsy and slurring his speech. His vital signs are as follows: heart rate 116 beats per minute, blood pressure 91/57 mmHg, oxygen saturation 96% on room air. Glasgow Coma Scale score is 11 out of 15. The results of his arterial blood gas (ABG) on room air are as follows:
pH: 7.24
pO2: 9.4 kPa
PCO2: 3.3 kPa
HCO3-: 22 mmol/l
Na+: 143 mmol/l
Cl–: 99 mmol/l
Lactate: 5 IU/l
Which SINGLE statement regarding this patient is true?
A 40-year-old man is brought to the Emergency Department by his wife after taking an excessive amount of one of his prescribed medications. Upon further inquiry, you uncover that he has overdosed on quetiapine. You consult with your supervisor about the case, and she clarifies that the symptoms of this type of poisoning are caused by the blocking of central and peripheral acetylcholine receptors.
What is one of the clinical effects that arises from the blockade of central acetylcholine receptors?
A 42-year-old woman with a long history of anxiety presents having taken a deliberate overdose of the pills she takes for insomnia. She informs you that the pill she takes for this condition is zolpidem 10 mg. She consumed the pills approximately 2 hours ago. She is currently hypotensive, with her most recent blood pressure reading being 82/56 mmHg. She weighs 70 kg. You administer a dose of calcium chloride, but there is no improvement in her condition.
Which of the following treatments is LEAST likely to be helpful in supporting her cardiovascular system?
A 42-year-old woman with a long history of anxiety presents having taken a deliberate overdose of the pills she takes for insomnia. She informs you that the pill she takes for this condition is zolpidem 10 mg. She consumed the pills approximately 2 hours ago. She is currently experiencing tachycardia, with her most recent heart rate reading being 120 beats per minute. She weighs 65 kg. You administer a dose of propranolol, but there is no improvement in her condition.
Which of the following treatments could now be given to support her cardiovascular system?
A 42-year-old woman with a lengthy history of depression arrives at the Emergency Department after intentionally overdosing on the medication she takes for her heart condition. She informs you that she consumed verapamil immediate-release 240 mg tablets approximately 30 minutes ago. However, her spouse promptly discovered her and brought her to the hospital. Currently, she shows no signs of symptoms. Typically, how much time passes before symptoms manifest in cases of this overdose?
A 68 year old male with dementia is brought into the emergency department by his daughter due to a sudden decline in cognitive function over the past week. The daughter suspects that the patient’s medication may have been altered recently. She presents you with the tablets she discovered in the patient’s room. Which medication is most likely responsible for the decline in the patient’s cognitive abilities?
A 35-year-old woman of Asian descent comes to the Emergency Department with swelling of the face, lips, and tongue. Despite receiving IM adrenaline, her symptoms do not improve. She mentions that her doctor recently prescribed her a new medication.
Which of the following drugs is most likely causing her symptoms?
A 57-year-old man comes in with bothersome swelling in both ankles. This has developed since he began taking a new medication for high blood pressure a couple of weeks ago.
Which medication is the MOST likely culprit for this side effect?
A 14 year old female is brought to the emergency department by her parents approximately 90 minutes after taking an overdose. The patient tells you she was at her friend’s house and they got into an argument which ended with her friend telling her she was ending their friendship. The patient grabbed a bottle of pills from the bathroom and swallowed all of them before leaving. She didn’t tell her friend she had taken the pills and wanted her to feel guilty but now regrets her actions. The patient tells you she didn’t read the name on the bottle and threw the bottle away as she walked home. The patient also tells you she didn’t see how many pills were in the bottle but thinks there were 20-30 of them. Several attempts to contact the patient’s friend to try and clarify the identity of the pills are unsuccessful. The patient advises you she feels nauseated and has ringing in her ears. You also note the patient is hyperventilating. A blood gas sample is taken and is shown below:
Parameter Result
pH 7.49
pO2 14.3 KPa
pCO2 3.4 KPa
HCO3- 25 mmol/L
BE -1
Which of the following best describes the acid base disturbance?