Match each clinical presentation of acute poisoning or overdose to the most appropriate initial specific antidote or pharmacologic therapy.
- A 24-year-old man is brought in unarousable with a respiratory rate of 6/min and pinpoint pupils.Administer naloxone
- A 32-year-old woman presents with right upper quadrant abdominal pain and markedly elevated aminotransferases 24 hours after a massive intentional ingestion of an over-the-counter analgesic.Administer N-acetylcysteine
- A 45-year-old man is brought in with severe bradycardia, hypotension, wheezing, and hypoglycemia after ingesting a handful of his blood pressure medication.Administer glucagon
- A 40-year-old man is evaluated for confusion, high anion gap metabolic acidosis, and acute kidney injury with calcium oxalate crystals in the urine after drinking antifreeze.Administer fomepizole
Answer
The presentations correspond to opioid, acetaminophen, beta-blocker, and ethylene glycol toxicity, which are definitively treated with naloxone, N-acetylcysteine, glucagon, and fomepizole, respectively.
Each patient presents with a classic toxidrome that pairs directly with a definitive, life-saving pharmacologic antidote based on known mechanisms of action and current clinical guidelines.
Step-by-Step Solution
Key Concept
Recognition and management of common toxidromes using specific antidotes.