NAPLEX Flashcards: Overdose And Exposure Management

What this deck covers

This deck focuses on Overdose And Exposure Management, giving you a quick way to review the definitions, rules, and examples that matter most for NAPLEX.

How to use these flashcards

Work through these flashcards in short sessions. Try to answer each prompt before flipping the card, then revisit any cards you miss until the explanation feels automatic.

Flashcard 1: Which antidote is used for acetaminophen overdose to prevent hepatic injury?

Answer: N-acetylcysteine (NAC). Replenishes glutathione to neutralize the hepatotoxic metabolite NAPQI in acetaminophen overdose.

Flashcard 2: Which antidote is used for digoxin toxicity with life-threatening arrhythmias or hyperkalemia?

Answer: Digoxin immune Fab. Binds free digoxin to form complexes that are rapidly excreted, reversing cardiac toxicity.

Flashcard 3: Which antidote is used for life-threatening bleeding from dabigatran?

Answer: Idarucizumab. Specifically binds dabigatran as a monoclonal antibody to neutralize its anticoagulant activity.

Flashcard 4: What complication can occur after naloxone in opioid-dependent patients?

Answer: Acute opioid withdrawal. Rapid opioid receptor displacement in dependent individuals precipitates symptoms like agitation and vomiting.

Flashcard 5: What is the first-line antidote for suspected opioid overdose with respiratory depression?

Answer: Naloxone. Competitively antagonizes mu-opioid receptors to rapidly reverse respiratory depression in opioid toxicity.

Flashcard 6: What is the goal of naloxone titration in opioid overdose management?

Answer: Restore adequate ventilation, not full arousal. Prioritizes reversing life-threatening respiratory depression while avoiding precipitation of severe withdrawal.

Flashcard 7: Which antidote is used for cyanide poisoning from smoke inhalation or industrial exposure?

Answer: Hydroxocobalamin. Chelates cyanide ions to form nontoxic cyanocobalamin for urinary excretion.

Flashcard 8: What is the preferred initial naloxone route for a layperson in the community setting?

Answer: Intranasal naloxone. Offers rapid absorption and user-friendly administration without needles, ideal for non-professionals.

Flashcard 9: Which agent is used for iron overdose to bind free iron and enhance elimination?

Answer: Deferoxamine. Chelates excess serum iron to form ferrioxamine, facilitating renal elimination and reducing toxicity.

Flashcard 10: Which antidote is used for benzodiazepine overdose when reversal is clearly indicated?

Answer: Flumazenil. Acts as a competitive antagonist at GABA_A receptors to reverse benzodiazepine-induced sedation.

Flashcard 11: Which antidote is used for symptomatic beta-blocker overdose with bradycardia or hypotension?

Answer: Glucagon. Stimulates cardiac adenylate cyclase independently of beta-receptors to improve hemodynamics.

Flashcard 12: Which medication is used to prevent recurrent hypoglycemia after sulfonylurea overdose?

Answer: Octreotide. Suppresses insulin release from beta cells to mitigate prolonged hypoglycemic effects of sulfonylureas.

Flashcard 13: What is the primary role of activated charcoal in overdose management when appropriate?

Answer: Adsorb drug in GI tract to reduce absorption. Binds toxins in the gastrointestinal lumen to limit systemic absorption and enhance fecal excretion.

Flashcard 14: Which antidote reverses warfarin anticoagulation in major bleeding or urgent procedures?

Answer: 4-factor PCC plus vitamin K. PCC rapidly replenishes clotting factors, while vitamin K sustains long-term reversal of warfarin.

Flashcard 15: Which antidote is first-line for organophosphate or carbamate poisoning with cholinergic symptoms?

Answer: Atropine. Blocks muscarinic receptors to counteract excessive cholinergic activity from cholinesterase inhibition.

Flashcard 16: Which antidote is used for hypoglycemia caused by insulin or sulfonylurea exposure?

Answer: Dextrose. Provides immediate glucose to correct severe hypoglycemia from excessive insulin or sulfonylurea action.

Flashcard 17: What is a major risk of flumazenil in chronic benzodiazepine users or mixed overdoses?

Answer: Seizures. Precipitates withdrawal in dependent users or unmasks convulsant effects in polydrug overdoses.

Flashcard 18: Which antidote is used for calcium channel blocker overdose to improve hypotension?

Answer: Calcium salts (calcium chloride or calcium gluconate). Overcomes channel blockade by increasing extracellular calcium to stabilize cardiac membranes.

Flashcard 19: What is the key lab value used to assess acetaminophen overdose severity and guide NAC need?

Answer: Serum acetaminophen concentration with time since ingestion. Plotted on the Rumack-Matthew nomogram to predict hepatotoxicity risk and determine treatment necessity.

Flashcard 20: Which therapy is recommended for refractory beta-blocker or calcium channel blocker overdose?

Answer: High-dose insulin euglycemia therapy (HIE). Enhances myocardial carbohydrate metabolism to provide inotropic support in refractory poisoning.

Flashcard 21: What is the preferred initial decontamination method for corrosive (acid/alkali) ingestion?

Answer: No GI decontamination; supportive care and urgent evaluation. Prevents further tissue injury by avoiding emesis or lavage that could exacerbate corrosive damage.

Flashcard 22: Which antidote treats methemoglobinemia from oxidizing agents when symptomatic?

Answer: Methylene blue. Accelerates methemoglobin reduction to hemoglobin via the NADPH-methemoglobin reductase pathway.

Flashcard 23: Which antidote is used for heparin-induced bleeding or excessive anticoagulation?

Answer: Protamine sulfate. Forms stable complexes with heparin to neutralize its anticoagulant effects and stop bleeding.

Flashcard 24: What adjunct antidote reactivates acetylcholinesterase in organophosphate poisoning?

Answer: Pralidoxime (2-PAM). Regenerates inhibited acetylcholinesterase by cleaving the organophosphate-enzyme bond.

Flashcard 25: Which antidote is used for life-threatening bleeding from apixaban or rivaroxaban?

Answer: Andexanet alfa. Serves as a decoy target for factor Xa inhibitors to restore normal hemostasis.