Antidotes

Antidotes- Toxicology what are Antidote? Antidote are substances which oppose the effects of poisons without causing damage to body Types of Antidotes 1:Mechanical or physical antidote: these substances prevents the absorption of poison by their presence eg:demulcents(fats,oils,milk,eggalbumin) are used for corrosive and irritant poisoning,Bulky food used for glass poisoning ,Activated charcoal is used for strychinine and mineral poisoning(dose 30-60 gms for childreb and 60-100gms ofr adults) 2:chemical antidotes:these substances neutrilize the chemical action or oxidize the poison into nontoxic or insolouble form eg:Dilute acetic acid,dilute alkali(milk of magnesia),tannin(strong tea),potassium permangante 3:physiological or pharmacological antidotes these produce effects opposite to that of poison eg:atropine and oxime for organophosphorous poison,naloxone for morphine, N-acetylcysteine for acetaminophen 4:chelating agents: these are substances which produce form chelates(non ionized comlexes) with cations...these are mostly used in heavymetal poisoning eg:EDTA is used in Arsenic,mercury,lead BAL(dimercepol) is used in heavy metal poisons versenate is used in Arsenic,mercury and lead N-pencillamine for mercury,lead,copper Desferoxamine is used for iron Universal Antidote:It is Given when unknown poison is ingested

Antidotes to Common Poisons: Acetominophen

Poison---------------------------------Antidote NAC(N-acetylcysteine)

Anticholinergics

Physostigmine

Anticoagulants (warfarin/coumadin,heparin)

Vitamin K1, protamine.

Benzodiazepines

Supportive Care, Flumazenil*

Botulism

Botulinum Antitoxin

Beta Blockers

Glucagon

Calcium Channel Blockers

Calcium, ?Glucagon?

Cholinergics

Atropine, Pralodixime in Organophosphate Overdose

Carbon Monoxide

Oxygen, Hyperbaric Oxygen

Cyanide

Amyl Nitrate, Sodium Nitrate, Sodium Thiosulfate, Hydroxycobalamin (Available in Europe).

Digoxin

Digoxin Fab Antibodies

Iron

Deferoxamine

Isoniazid

Pyridoxine

Lead

BAL, EDTA, DMSA

Methemoglobinemia

Methelene Blue

Opiods

Naloxone

Toxic Alcohols

Ethanol Drip, Dialysis. Experimental trials underway on Enzyme Inhibitors.

Tricyclic Antidepressants Sodium Bicarbonate *Use of flumazenil contraindicated in many situations including tricyclic overdose or in chronically habituated benzodiazepine users, as this may precipitate seizures. Disclaimer!: Once again, this is useful as an educationa tool, and may not represent standard of care in your area. Please consult a poison control center in case of emergency.

Antidotes to Common Poisons: Acetominophen

Poison---------------------------------Antidote NAC(N-acetylcysteine)

Anticholinergics

Physostigmine

Anticoagulants (warfarin/coumadin,heparin)

Vitamin K1, protamine.

Benzodiazepines

Supportive Care, Flumazenil*

Botulism

Botulinum Antitoxin

Beta Blockers

Glucagon

Calcium Channel Blockers

Calcium, ?Glucagon?

Cholinergics

Atropine, Pralodixime in Organophosphate Overdose

Carbon Monoxide

Oxygen, Hyperbaric Oxygen

Cyanide

Amyl Nitrate, Sodium Nitrate, Sodium Thiosulfate, Hydroxycobalamin (Available in Europe).

Digoxin

Digoxin Fab Antibodies

Iron

Deferoxamine

Isoniazid

Pyridoxine

Lead

BAL, EDTA, DMSA

Methemoglobinemia

Methelene Blue

Opiods

Naloxone

Toxic Alcohols

Ethanol Drip, Dialysis. Experimental trials underway on Enzyme Inhibitors.

Tricyclic Antidepressants Sodium Bicarbonate *Use of flumazenil contraindicated in many situations including tricyclic overdose or in chronically habituated benzodiazepine users, as this may precipitate seizures. Disclaimer!: Once again, this is useful as an educationa tool, and may not represent standard of care in your area. Please consult a poison control center in case of emergency.

An antidote is a substance which can counteract a form of poisoning.[1] The term ultimately derives from the Greek αντιδιδοναι antididonai, "given against". The antidotes for some particular toxins are manufactured by injecting the toxin into an animal in small doses and extracting the resulting antibodies from the host animals' blood. This results in an antivenom that can be used to counteract poison produced by certain species of snakes, spiders, and other venomous animals. A number of venoms lack a viable antivenom, and a bite or sting from an animal producing such a toxin often results in death. Some animal venoms, especially those produced by arthropods (e.g. certain spiders, scorpions, bees, etc.) are only potentially lethal when they provoke allergic reactions and induce anaphylactic shock; as such, there is no "antidote" for these venoms because it is not a form of poisoning and anaphylactic shock can be treated (e.g., by the use of epinephrine). Some other toxins have no known antidote. For example, the poison aconitine, a highly poisonous alkaloid derived from various aconite species has no antidote, and as a result is often fatal if it enters the human body in sufficient quantities.

Mechanical approaches Ingested poisons are frequently treated by the oral administration of activated charcoal, which adsorbs the poison and flushes it from the digestive tract, thereby removing a large part of the toxin.A remedy: Poisons which are injected into the body (such as those from bites or stings from venomous animals) are usually treated by the use of a constriction band which limits the flow of lymph and/or blood to the area, thus slowing circulation of the poison around the body. This should not be confused with use of a tourniquet which cuts off blood flow completely - often leading to the loss of the limb.

List of antidotes Agent Activated charcoal with sorbital Atropine Beta Blocker Calcium chloride Calcium gluconate Chelators such as EDTA, dimercaprol (BAL), penicillamine, and 2,3-dimercaptosuccinic acid (DMSA, succimer) Cyanide antidote (amyl nitrite, sodium nitrite, or thiosulfate) Cyproheptadine Deferoxamine mesylate Digoxin Immune Fab antibody (Digibind and Digifab) Diphenhydramine hydrochloride and benztropine mesylate Ethanol or fomepizole Flumazenil Glucagon 100% oxygen or hyperbaric oxygen therapy (HBOT) Insulin Leucovorin Methylene blue Naloxone hydrochloride N-acetylcysteine Octreotide Pralidoxime chloride (2-PAM) Protamine sulfate Prussian blue Physostigmine sulfate Pyridoxine Phytomenadione (vitamin K) and fresh frozen plasma Sodium bicarbonate

Indication used for many oral toxins organophosphate and carbamate insecticides, nerve agents, some mushrooms theophylline calcium channel blockers, black widow spider bites hydrofluoric acid heavy metal poisoning cyanide poisoning serotonin syndrome Iron poisoning digoxin poisoning Extrapyramidal reactions associated with antipsychotic ethylene glycol poisoning and methanol poisoning benzodiazepine poisoning beta blocker poisoning and calcium channel blocker poisoning carbon monoxide poisoning and cyanide poisoning beta blocker poisoning and calcium channel blocker poisoning methotrexate and trimethoprim treatment of conditions that cause methemoglobinemia fritz pogi opioid poisoning Paracetamol (acetaminophen) poisoning oral hypoglycemic agents organophosphate insecticides Heparin poisoning Thallium poisoning anticholinergic poisoning Isoniazid poisoning, ethylene glycol warfarin poisoning and indanedione ASA, TCAs with a wide QRS