2 - Reversal/Rescue Agents/Antidote Flashcards
Antidote
Ergotamine
Nitroprusside
Rebound Hypertension
Phentolamine
Orthostatic HYPERTENSION
- Midodrine
Orthostatic HYPOtension
- Yohimbine (a2 antagonist)
Organophosphate poisoning
Pralidoxeme
(+ atropine)
DUMBBELSS
- diarrhea
- urination
- miosis
- bronchospasm
- bradycardia
- excitation (skeletal muscle and CNS)
- lacrimation
- sweating
- salivation
Muscarinic agent overdose
Cholinesterase inhibitors
Atropine
Methemoglobinemia
Methylene Blue
Cyanide poisoning
Lilly cyanide kit
+ IV sodium amyl nitrite
+ IV sodium thiosulfate
Antidote:
Hydroxycobalamine
Class 1A antiarryhthmic overdose
- Quinidine
- Procainamide
- Disopyramide
Sodium lactate
Digoxin-induced arryhthmia
Lidocaine
- DOC for ventricylar arryhthmia post-MI
Doxorubicin toxity
Dexrazoxane
Rocuronium
Suggamadex
Opioid toxicity
Naloxone
Methotrexate toxicity
Leucovorin
Heparin
- PTT
- Intrinsic
- activates antithrombin III which inactivates thrombin/IIa/IXa/Xa
Protamine sulfate
Warfarin
- INR
- PT
- Extrinsic
- Category X
Immediate: FFP / Prothrombin complex concentrate
Not immediate: Vitamin K
Cyclophosphamide
- hemorrhagic cystitis
Metabolite: Acrolein
MESNA
Methanol toxicity
Fomepizole
Benzodiazepine toxicity
Flumazenil
B-blocker overdose
Theophylline
Lidocaine systemic toxicity
Intralipid
Acetaminophen toxicity (Paracetamol) - to prevent fulminant hepatitis
N-acetylcysteine
- also used to resurrect reduced form of glutathione that works as an antioxidant to counteract the reactive metabolite of acetaminophen (NAPQ1 free radical)
Iron intoxication - hemochromatosis TRIAD: - cirrhosis - DM - skin pigmentation
Deferoxamine
- heavy metal chelator
ACUTE: deferoxamine (IV)
CHRONIC: deferasirox and Deferipone (oral)
Dabigatran toxicity
- direct anticoagulant
- binds to active site of thrombin and inhibits enzymatic action
Idarucizumab
- needs dose adjustment for renally impire patients
Alteplase/Streptokinase
- thrombolytic
- tissue plasminogen activator (tPA) analogue
- converts plasminogen to plasmin which degrades fibrin and fibrinogen
Aminocaproic Acid
- Tranexamic acid
AV nodal blockade caused by Beta 1 blockers antidote
Glucagon
Reverse neuromuscular blockade of aminoglycosides (Neomycin/Kanamycin/Paromomycin)
Calcium gluconate and neostigmine
Severe cases of Chronic inorganic lead poisoning (plumbism)
EDTA +/- dimercaprol
Outpatients: chronic inorganic lead poisoning (plumbism)
Oral Succimer
Carbon monoxide
100% oxygen
Hyperbaric oxygen accelerates clearance
Acute and chronic arsenic poisoning
Dimercaprol
Acute inorganic mercury poisoning
Oral succimed or IM Dimercaprol
Chronic inorganic mercury poisoning
Succimer and unithiol
DO NOT us dimercaprol - redistribution to the CNS
Lead poisoning
Succimer
- administered at blood lead concentrations >45mcg/dL
Copper poisoning
Penicillamine (DMARD)
Antimuscarinic poisoning
Physostigmine
- may be helpful
- NOT for tricyclic overdose
Quinidine, TC-s
Bicarbonate
Fluoride, CCBs
Calcium
Digoxin
Digitalis toxicity
Lidocaine
- DOC
Digoxin antibodies (Digibind) - may save patient who would otherwise die
Caffeine, Theophylline, sympathomimentics
Esmolol
Methanol, Ethylene glycol
Ethanol
Benzodiazepines, Zolpidem
Flumanezil
Methanol, Ethylene glycol
Fomepizole
Hypoglycemics
Glucose
Amanita mushroom poisoning
Milk thistle
Cisplatin rescue therapy
Amifostine
Nitroglycerin tolerance
Glutathione
Alpha-1 agonist overdose
Phentolamine
Local Anesthetic Systemic Toxicity (LAST)
Intralipid
Alteplase
- tissue plasminogen activator analogue
- thrombolytic
Aminocaproic acid