Symptoms and physical findings

Laboratory Findings

Antidote

Paracetamol

Nausea, vomiting, malaise, right upper quadrant abdominal pain, jaundice, confusion, somnolence; coma may develop later

After 24 hrs, increased AST (>1,000 IU/L is characteristic), increased ALT, increased bilirubin

n-Acetylcysteine

Tricyclic antidepressants

CNS excitability, confusion, blurred vision, dry mouth, fever, mydriasis, seizures, coma, arrhythmias, hypotension, tachycardia, respiratory depression; physical condition can rapidly change

ECG findings of increased QRS interval > 0.10 seconds, sinus tachycardia, conduction abnormalities

Bicarbonate

Benzodiazepines

Drowsiness, lethargy, dysarthria, ataxia, hypotension, hypothermia, coma, respiratory depression with severe overdoses

No characteristic findings

Flumazenil

Narcotics
(opioid)

Drowsiness, nausea, vomiting, miosis, respiratory depression, cyanosis, coma, seizures, bradypnea, noncardiac pulmonary edema

With severe respiratory depression, hypoxemia, hypercarbia, respiratory acidosis, rhythm disturbances, pulmonary edema

Naloxone