Antidotes Flashcards

1
Q

Anticholinergics

A

Agents: atropine, diphenhydramine, dimenhydrinate, scopolamine

Sx: flushing, dry skin, mydriasis w/ blurred vision, AMS, fever
(red as a beet, dry as a bone…)

Tx: physostigmine

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2
Q

Warfarin

A

Sx: bleeding

Tx: phytonadione (vitamin k), PCC (kcentra)

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3
Q

Factor Xa inhibitors

A

Sx: bleeding

Tx:
Andexxa -apixaban, rivaroxaban
PCC (kcentra) - factor Xa inhibitors

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4
Q

Dabigatran

A

Sx: bleeding

Tx: Idarucizumab (Praxbind)

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5
Q

Heparin, LMWH

A

Sx: bleeding

Tx: Protamine

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6
Q

Antipsychotics

A

Tx: benztropine for dystonias

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7
Q

BZD

A

Agents: Valium, Xanax, Ativan, Klonopin

Tx: Flumazenil

can cause seizures in patients on BZD chronically

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8
Q

Beta-blockers

A

Tx: Glucagon if unresponsive to symptomatic treatment

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9
Q

CCB

A

Tx: IV Calcium (chloride or gluconate)

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10
Q

Cyanide

A

Agents: Nitroprusside (in high doses/long durations/renal impairment)

Tx: Hydroxocobalamin (Cyanokit)

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11
Q

Lanoxin

A

Digoxin Immune Fab (DigiFab)

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12
Q

Ethanol

A

Sx: can cause an ↑anion gap

Tx: thiamine (vitamin B1) to prevent Wernicke’s encephalopathy

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13
Q

Heavy metals

A

Tx:
arsenic, gold, mercury - Dimercaprol
lead - Succimer + DMSA
copper - Penicillamine

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14
Q

Hydrocarbons (petroleum products)

A

Do not induce vomiting
NPO due to aspiration risk

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15
Q

Insulin

A

Dextrose (do not admin if patient unconscious)
Glucagon

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16
Q

Isoniazid

A

Pyridoxine (vitamin B6)

17
Q

Iron

A

Deferoxamine (Desferal)

18
Q

Organophosphates
(industrial insecticides)

A

MOA: OPs block acetylcholinesterase (↑ACh levels)

↑ACh = SLUDD symptoms

Tx:
Atropine - anticholinergic
Pralidoxime - relieves paralysis by reactivating cholinesterase

Atropine & Pralidoxime combo

19
Q

Neostigmine, pyridostigmine

A

pralidoxime

20
Q

Nicotine

A

Sx: abdominal pain, nausea

Tx:
supportive care
atropine - for symptomatic bradycardia
BZD for seizures

21
Q

Paralytics

A

Neostigmine - rocuronium, vecuronium, pancronium
Sugammadex - rocuronium & vecuronium

22
Q

Salicylates

A

General concept: ↑ excretion
weak base: acidify the urine
weak acid: alkaline the urine

Tx:
Nabicarb (alkalinizing agent) -
↓ drug reabsorption and ↑ excretion

23
Q

Stimulant overdose

A

Agents: amphetamines, ADHD & weight loss drug

Tx: BZD

24
Q

Toxic alcohols

A

Agents: ethylene glycol (antifreeze), methanol

can cause an ↑ anion gap

Tx: Fomepizole

25
Q

TCA

A

can cause fatal arrhythmias

Tx:
Na-Bicarb: to ↓ wide QRS complex

26
Q

VPA or topiramate-induced hyperammonemia

A

Levocarnitine (Carnitor)