MedBugs: SAQ #410

Case: Digoxin and propranolol overdose

A 19-year-old female presents 2 hours post an intentional drug overdose. She admits to taking 250 tablets of digoxin 62.5mcg (equivalent 15.6mg) and 40 tablets of propranolol 10mg. Her observations are:

GCS 15
RR 14
Sats 98%RA
HR 43
BP 92/54

1. In addition to cardiovascular effects, list clinical features each from a different physiological system that may already be present in this patient at the time of triage. 3 marks

2. What’s the ECG diagnosis? 1 mark

3. State other dysrhythmias commonly associated with acute digoxin toxicity. 2 marks

The patient will require urgent treatment of the combined overdose.

4. List the antidote and other treatments, with doses, specific to each drug. 6 marks

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Case: Digoxin and propranolol overdose

1. In addition to cardiovascular effects, list clinical features each from a different physiological system that may already be present in this patient at the time of triage. 3 marks

2. What’s the ECG diagnosis? 1 mark

3. State other dysrhythmias commonly associated with acute digoxin toxicity. 2 marks

4. List the antidote and other treatments, with doses, specific to each drug. 6 marks

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