General Treatment Guidelines

The agents discussed in this chapter share certain generalities useful in guiding management ( Table 159-3). Most overdoses of nonbenzodiazepine sedative-hypnotics are taken orally and often involve coingestants. Therefore, a diligent search for other treatable substances (e.g., acetaminophen and salicylates) is mandatory. Coingestants also may obscure expected toxidrome features or potentiate symptoms, complicating management. All the agents discussed, with the possible exceptions of buspirone, zolpidem, and GHB, cause physical dependence and tolerance in chronic use. Thus hospitalized patients who have been treated for acute toxicity subsequently may develop life-threatening abstinence states that are best anticipated from the ED.

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