Risk Assessment for a drug overdose Introduce self Identify patient Gain consent for history What tablets were taken Number of tablets Strength/dose of tablets Taken at once ot staggered When was the last tablet given Was anything else taken with the tablets Location of attempt Planning Perceived lethality of attempt Was the patient intoxicated What were you intending out of it? Thoughts before attempt Protective factors that could have stopped Thoughts after attempt Exploration of risks to others, pets or property Exploration of risks of others towards the patient Management ABC Vital monitoring Decontamination if appropriate Gastric lavage if ingestion is recent or activated charcoal Activated charcoal is given orally to absorb toxins from the stomach We use a large pore NGT Activated charcoal can be administered to prevent further damage Typically, after 1 to 2 hours of a life-threatening overdose Should not be attempted when the substance taken is corrosive or volatile as it could worsen the damage to the GIT Contraindicated if the patient is unconscious or cannot protect the airway unless intubated or if a patient has a hemorrhages , coagulopathies, Whole bowel irrigation administering large volumes of a polyethylene glycol-electrolyte solution to empty the gastrointestinal tract and reduce drug absorption SPECIFIC DRUG CARE Opioid Naloxone Benzos Flumazenil Paracetamol N-acetylcysteine -> to prevent liver damage Replenishes glutathione stores -> natural antioxidant of the the live that neutralises N-acetyl-p-benzoquinone imine (NAPQI) Beta blockers of calcium channel blockers Glucagon or calcium gluconate TCA Sodium bicarbonate -> to correct acidosis Alcohol Fomepizole -> inhibits metabolism of toxic drugs SUPPORTIVE CARE IV fluids Seizure management -> e.g. benzothiazine if a seizure occurs Electrolytes and glucose monitoring Psychiatric evaluation