Paeds Cases · clinical-pharmacology-and-therapeutics
Pick the right antidote — poisoning antidotes and toxicology pharmacology
A bedside structured clinical encounter testing recognition of an opioid toxidrome and the weight-based naloxone response, the decision to start N-acetylcysteine for a staggered paracetamol ingestion, and the construction of a safe antidote plan that avoids the flumazenil trap.
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Candidate instructions
You are the emergency-department registrar receiving a four-year-old, 16-kilogram boy brought in by paramedics after being found unresponsive at home. Opened bottles of paracetamol and his grandmother's temazepam were beside him. You have eight minutes to resuscitate, choose and dose the antidotes, defend your reasoning to the examiner, and build a safe plan. [3] [1]
You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.
References4Show ledgerHide ledger
- [1]Dart RC, Mullins ME, Matoushek T, et al. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement JAMA Network Open, 2023.PMID 37552484
- [3]Boyer EW Management of opioid analgesic overdose New England Journal of Medicine, 2012.PMID 22784117
- [4]Malmros Olsson E, Lönnqvist PA, Stiller CO, et al. Rapid systemic uptake of naloxone after intranasal administration in children Paediatric Anaesthesia, 2021.PMID 33687794
- [8]Fine JS Iron poisoning Current Problems in Pediatrics, 2000.PMID 10742921