Module 2 - Antidiabetic drugs, Analgesics and NSAIDs, Opioids, Methotrexate and Colchicine

At the end of this module, students should be able to:
· Understand the mechanisms underlying the toxicity of these agents
· Undertake a risk assessment of poisoning
· Be aware of agents that have a delayed onset or protracted time course of poisoning and how patients should be monitored
· Understand the role and limitations of specific antidotes, where available
· Develop an approach for the treatment of these drugs, as single ingestants or co-ingestants.

• Understand the mechanism of toxicity and clinical effects including time course of hypoglycaemic agents
• Understand the role of antidotes in hypoglycaemic poisoning
• Understand some of the complexities in a medicolegal toxicology case

Biguanides, Sulphonylureas and Insulin

See: Problems for Discussion

Objectives

• To be able to do a risk assessment of a paracetamol poisoning
  • Consider variables which may affect the risk assessment
• Understand the limitations of the nomogram
• Understand treatment of paracetamol poisoning
• Discuss the effective methods of gastric decontamination in paracetamol overdose
• Discuss the efficacy of available antidotes based on strength of evidence
• Discuss the problems of management when working in resource poor settings
• Compare the differences in prognosis and management in acute deliberate and accidental paracetamol overdose.

Reading

WikiTox Acetaminophen

See: Problems for Discussion

Objectives

• Understand the mechanism of toxicity of NSAIDs.
• Understand the potential complications of NSAID overdose in general and which agents have specific toxicities.

Reading

Analgesics and Anti-inflammatory NSAID Poisoning

See: Problems for Discussion

WikiTox Opioids

See: Problems for Discussion

WikiTox Methotrexate

See: Problems for Discussion

• Understand the mechanism of toxicity
• Be able to make a risk assessment
• Understand the issues underlying the provision of antidotes

Colchicine

See: Problems for Discussion