Anion gap normal range
12-16 mEq/L
Anion gap
Sodium + potassium / bicarb + chloride
Large anion gap indicates
Renal failure and lactic acidosis
Osmol gap normal
0
Osmol gap
Measured - calculated
Osmol gap equation
2 x Na + glucose/18 + BUN/3
Osmol gap greater than 3 indicates
Alcohol presence
Large Vd
Vd greater than 5
Large Vd distributed
In tissues
,Drugs with large Vd
Antidepressants, antipsychotic, anti-malarials, opioids, Verapmil
Small Vd is
Vd less than 1
Small Vd is distributed
In blood & ECF
Small Vd drugs
Salicylate, acetaminophen, ethanol, lithium, phenytoin
Methanol and ethylene glycol antidote
Ethanol, fomepizole
Benzo antidote
Flumanezil
Acetaminophen toxicity in adults
7g
Acetaminophen max adult dose
4g
Acetaminophen symptoms
Asymptomatic, mild GI upset, liver failure, kidney injury
, Acetaminophen antidote
N-acetylcysteine
N-acetylcysteine
Acts as glutathione
Binds to toxic metabolite
Cyanide antidote
Cyanokit and kit of nitrate & sodium thiosulfate
Cyanide MOA
Bind to cytochrome oxidase
Inhibits O2 binding
Cyanide symptoms
SOB, agitation seizures coma
Snake venom antidote
Crofab/anti venom
Snake venom symptoms
Vomiting, metallic taste in mouth, shock, pain, swelling, fang marks
Neuronopathy
Death of neuron
Drugs that cause neuronopathy
CO, EtOH, Pb, methyl mercury, carbon tetra, ROS