Toxic at low dose.
What drug is responsible for over half the accidental deaths of toddlers?
The research was done in England and Wales (the country not the species). Availabilty and potency makes it so dangerous.
What is the Poisons Hotline number in Australia?
132500 is NSW State Emergency service, 131114 Life Line, 131444 NSW Police---but the one you really need to remember for Poisons is 131126.
A toddler sucked on a bottle of "Clear eyes" allergy eye drops. What drug commonly used in the treatment of ADHD will it mimic in overdose?
The drug in "Clear Eyes" is Naphazoline which is one of the imidazoline compounds. It acts systemically on similar receptors to clonidine causing a biphasic CVS response with initial hypertension and tachycardia then hypotension and bradycardia. At high doses causes decreased LOC and respiration. A similar drug is in Visine eye drops. Nasty.
A 18mth old boy presented with a generalised seizure due to hypoglycemia precipitated by ingesting 2 of his grandmother's Glipizide tablets. What dose of IV Glucose is recommended?
2mls/kg of 10% Dextrose is what you give in APLS when the BSL is found to be <3mmol/l. However in the setting of an overdose of an oral hypoglycemic you need higher doses of Dextrose and will likely need repeat doses of Dextrose and a Dextrose infusion.
In Chicago, 1982, 7 people were killed after ingesting Tylenol (Paracetamol) extra strength pills. They had been maliciously tampered with a toxic substance. What was that substance?
The killer was never found. The deaths changed the packaging and anti tampering laws in the USA. If you want to know more it was made into a Netflix mini series in 2025. Below is a link to the official trailer.
A 4yr old boy has likely taken 5 Verapamil 180mg SR tablets 45min ago. He has a normal level of consciousness but is bradycardic at 64/min and has a BP of 70/50. Which of the following is he NOT likely to require?
This child is very likely to develop cardiovascular collapse as he is aleady showing the effects on his heart and vasodilation. Guided by Poisons information he is likely to get the top 3 answers however usually you tend to develop hyperglycemia not hypoglycemia in calcium channel overdoses.
A 3yr old girl, who weighs 15kg, ate a teaspoon of Vicks Vapo Rub. What of the following should you do?
The major toxin will be Camphor. At this dose (works out to be about 25mg/kg camphor) you may see confusion and possibly seizures and well as gastrointestinal irritation. Activated charcoal will not work and inducing vomiting is contraindicated. The major problems are neurological and respiratory, not cardiovascular. (Ring 131126)
A 48yr old lady was frustrated with the lack of effects of topical "Oil of Wintergreen" linament. Unwisely she decided to drink 30mls to see if that would help. How many equivilant 300mg Aspirin tablets has she just taken?
Oil of Wintergreen is 67% Methyl Salicylate and 22% Turpentine oil. Highly toxic. Anticipate severe salicylism clinically.
A 3yr old was seen by his father to put a small amount of the podophylline 25% solution he has been using for the topical use on his warts. What more well known drug is it like in overdose?
Ring 131126. This is potentially very nasty. The toxic dose for a toddler is a fraction of a teaspoon. It is a cellular poison, rapidly absorbed that inhibits mitosis (which you need). All treatment is supportive.
The clip is from a 1944 movie where 2 elderly ladies poison elderly lonely men. What is the main part of the poison they put into the elderberry wine and give the men to drink?
It's in the name of the movie "Arsenic and old lace"---quirky and classic black comedy. Arsenic was considered the "king of poisons" because it was odourless and almost tasteless when mixed in wine. (the ladies used an Arsenic, Cyanide, Strychnine combo).