NAC dosing regimens
The Paracetamol page has been updated with some additional information about the growing number of NAC dosing schedules currently in use.
Toxicology
Beta blocker toxicity
A few minor updates have been made to the Beta blockers page.
Tramadol toxicity
The Opioids page has been updated with additional information about the toxicity of tramadol, especially the risk of hypoglycaemia.
IM slow release naltrexone
Some information about slow release naltrexone has been added to the Opioid antagonists and partial antagonists page.
Physostigmine in anticholinergic delirium
The Anti-muscarinic agents page has been updated with additional information about the effectiveness of physostigmine.
Effects of moderate drinking on cognition
The Ethanol page has been updated with additional information about the effects of chronic moderate ethanol ingestion on cognition. Topiwala, A, Allan, CL, Valkanova, V, et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ 2017;357:j2353
Haemodialysis in salicylate toxicity
The important benefit of haemodialysis in intubated patients with salicylate toxicity has been emphasised on the Salicylates page.
Cardiovascular effects of alcohol
The Ethanol page has been updated with information about the cardiovascular effects (potentially beneficial and harmful) of alcohol consumption.
Torsades de pointes ECG
The Potassium channel blocking agents page has been updated with a 3 lead ECG demonstrating torsades de pointes.
Prolonged QTc ECG
The Potassium channel blocking agents page has been updated with a 12 lead ECG demonstrating a prolonged QTc.
Benzodiazepine dependence
The Illicit drugs page has been updated to include a segment on Benzodiazepine dependence. Soyka, M. Treatment of Benzodiazepine Dependence. NEJM 2017;376(12):1147-57
E-cigarettes and carcinogen exposure
The Smoking page has been updated with information indicating that smokers of e-cigarettes appear to have lower exposure to potential carcinogens than regular smokers.
2-4 hour paracetamol levels
The Paracetamol page has been updated with information about the utility of a 2-4 hour paracetamol level in predicting subsequent potential toxicity. Yarema, MC, Green, JP, Sivilotti, MLA, et al. Can a serum acetaminophen concentration obtained less than 4 hours post-ingestion determine which patients do not require treatment with acetylcysteine? Clinical Toxicology 2016:1-7.
Calcium channel antagonist toxicity
The Calcium channel antagonists page has been revised following the publication of the following article. St-Onge, M, Anseeuw, K, Cantrell, FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Critical Care Medicine 2016.
Wernickes
The Ethanol page has been updated with some additional information about Wernicke’s encephalopathy.
Paracetamol ingestion algorithm
The Paracetamol ingestion algorithm on the Paracetamol page has been updated with the expanded indications for oral activated charcoal contained in the September 2015 Australian management guidelines.
Paracetamol toxicity
Some minor revisions to the Paracetamol page have been made, including the NNT (7) for charcoal within 2 hours of ingestion.
Buprenorphine
Some additional information about buprenorphine has been added to the Opioid antagonists & partial antagonists page.
Tolerance, dependence and addiction
The Illicit drug use page has been revised including a better description of the differences between drug tolerance, dependence and addiction.
Management of withdrawal in patients on MATOD
Additional information about the management of opioid withdrawal in patients on medication assisted treatment for opioid dependence (MATOD) has been added to the Opioid antagonists & partial antagonists page.