Commonly Overdosed Medications

For a variety of reasons, patients will take more than the prescribed amount of a medication. The reasons for overdosing range from intentional (suicidal or recreational) to accidental.

• The most common overdose that EMS will encounter is insulin. Patient’s take insulin at various times of the day, but fail to properly measure the amount of insulin they take. The result is hypoglycemia.
• Cardiac medications – Most cardiac medications are intended to control heart rate (more times than not slow it down) or blood pressure medications. These powerful drugs must be taken in accordance with their prescription else the medics may find the patient lying on the floor with a slow heart rate and hypotension. Sometimes these medication overdoses are the result of the pharmacist error when filling the prescription.
• Psychiatric medications – The best candidate for overdose is Benzodiazepines such as Xanax. These medications are overdosed and combined with narcotics and alcohol with lethal effects. Benzodiazepine overdoses usually present a patient with snoring respirations and vomiting. Antidepressants such as Paxil or Prozac are routinely overdosed, and present with bizarre and even homicidal mood shifts.
• Non-Prescription Pain Medications Including Salicylates And Acetaminophen – The most common overdose is Acetaminophen. At various concentrations, Acetaminophen is hepatotoxic (toxic to the liver).

Initial management is always guided by the primary survey. If the patient is unresponsive the medics could discover an overdose by running through the NACHOS pneumonic. If the patient is conscious, inquiring about medications may reveal an overdose. For EMS, management of the patient typically involves contacting poison control and transporting to the Emergency Department.