6. If a patient has overdosed on paracetamol for 8-24hrs, what is the next step?

Start N-acetylcysteine, check paracetamol levels (if levels are below treatment line, discontinue - if levels above treatment line continue treatment) and measure AST/ALT
Check paracetamol levels and plot against time on the nomogram (if above or on the treatment line, administer N-acetylcysteine)
Activated charcoal and do paracetamol levels 4 hrs from time of ingestion
Start N-acetylcysteine immediately and check paracetamol levels (if levels are below treatment line, discontinue - if levels above treatment line continue treatment)
Do paracetamol levels from 4hrs of time of ingestion. If toxic dose taken then start N-acetylcysteine

7. Which of the following are activities an epileptic can undertake?

Medication is temporary, as condition always subsides after a couple of years strict use
A procedure to put a small electrical device inside the body that can help control seizures
A special diet (ketogenic diet) that can help control seizures
Anti-epileptic drugs – these are the main treatment
Surgery to remove a small part of the brain that's causing the seizures

Cyclic periods of feeling particularly high and low
Feeling that someone or something has taken out thoughts/ideas from your head/brain
Fear that people are out to get you
Hearing voices that other people cannot hear
Feeling that someone or something has put thoughts/ideas into your head

Lifelong condition that can sometimes cause serious disability, although it can occasionally be mild
Is an autoimmune condition. This is when something goes wrong with the immune system and it mistakenly attacks a healthy part of the body – in this case, the brain or spinal cord of the nervous system
It's about 2 to 3 times more common in men than women and is 1 of the most common causes of disability in younger adults
Is a condition that can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance
Exactly what causes the immune system to act in this way is unclear, but most experts think a combination of genetic and environmental factors is involved
It can occur at any age, but mostly occurs in the late 20s or early 30s

Quite smoking
Balanced diet (add fruit, vegetables and milk)
Informa close family and friends (assist to keep environment safe around patient in case of fits)
Avoid or minimally consume alcohol

Check paracetamol levels and plot against time on the nomogram (if above or on the treatment line, administer N-acetylcysteine)
Start N-acetylcysteine immediately and check paracetamol levels (if levels are below treatment line, discontinue - if levels above treatment line continue treatment)
Start N-acetylcysteine, check paracetamol levels (if levels are below treatment line, discontinue - if levels above treatment line continue treatment) and measure AST/ALT
Do paracetamol levels from 4hrs of time of ingestion. If toxic dose taken then start N-acetylcysteine
Activated charcoal and do paracetamol levels 4 hrs from time of ingestion

Enquire about their past medical hx, to know if they have been diagnosed with any psychiatric conditions
Take a social hx, to know the patient's living conditions/situation, if they've had social problems (with the law, with finances, with friends/family relations) etc.
Talk to the patient about how illicit drug are wrong and that he/she must make an effort to not relapse
Get a detailed illicit drug history, to known what was taken, how it was financed, if they have support (family/friends), tolerance, taking any alcohol or smoking etc.
Enquire about their past medical hx, to know if they have been diagnosed with any medical conditions

Allow patient to go home and return once she has sorted her childcare problems to start treatment immediately
Explain to patient that they need to be admitted, and explain that the levels of paracetamol are too high and require treatment
Empathize that you understand it is inconvenient, but strongly emphasize that it's for the patient's health and safety
Ask patient if they have anyone else that could take care of the children, as admission of 24-48hrs is required
Let patient know that hospital can provide temporary carers at patient's place to cover admission duration

Do paracetamol levels from 4hrs of time of ingestion. If toxic dose taken then start N-acetylcysteine
Check paracetamol levels and plot against time on the nomogram (if above or on the treatment line, administer N-acetylcysteine)
Start N-acetylcysteine, check paracetamol levels (if levels are below treatment line, discontinue - if levels above treatment line continue treatment) and measure AST/ALT
Activated charcoal and do paracetamol levels 4 hrs from time of ingestion
Start N-acetylcysteine immediately and check paracetamol levels (if levels are below treatment line, discontinue - if levels above treatment line continue treatment)

Information given to patient in case he/she needs to contact us
Discuss about expected possible withdrawal symptoms (medications may be given to prevent or reduce this)
Keyworker will be seen every few weeks on one-to-one basis during treatment
Keyworkers help organise treatment in a personalised care plan and first point of call throughout treatment
Needle syringe programme (local hospital to pick up clean needles and syringes) - to reduce risk of contracting infections by sharing used needles
Support groups (meet successful people who have stopped using recreational drugs and share experiences)
Local drug treatment service (assessed and may be assigned a keyworker)
Encouragement: "With the right help and support, it is possible for you to become drug free and stay that way"

May take up to 6 weeks to feel the full benefits
Treatment course is usually for at least 6 months (may be longer or indefinitely in people with recurrent problems)
Stopping treatment suddenly can cause problems (gradual dose reduction)
Used for alcoholic patients, as a deterrent by causing unpleasant physical reactions (e.g. nausea, vomiting, chest pain, dizziness)
May give thoughts of suicide or self harm