Antidotes Flashcards
Acetaminophen
N-acetylcysteine (replenishes glutathione)
Salicylates
NaHCO3 (alkanizes urine) + dialysis
Amphetamines
NH4Cl (acidifies urine) - weak base
Acetylcholinesterase inhibitors (organophosphates)
Atropine, pralidoxime (2-PAM) - regenerates non-aged AChE
Antimuscarinic, anticholinergic agents (e.g. Atropine or Jimson Weed OD)
Physostigmine, control hyperthermia
Beta-blockers
Glucagon
(the likely mechanism of action is the increase of cAMP in the myocardium, in effect bypassing the β-adrenergic second messenger system)
Digitalis
Normalize K, Lidocaine, Ant-dig FaV, Mg
(KLAM)
Iron
Deferoxamine, deferasirox
(Chelators)
Lead
CaEDTA, dimercaprol, succimer, pencillamine
Mercury, arsenic, gold
Dimercaprol (BAL), succimer
Copper, arsenic, gold
Pencillamine
Cyanide
Nitrite + thiosulfate, hydroxocobalamin
Methemoglobin
Methylene Blue, vitamin C
Carbon monoxide
100% O2, hyerbaric O2
Methanol, ethylene glycol (antifreeze)
Fomepizole > ethanol, dialysis
Fomepizole is a competitive inhibitor of alcohol dehydrogenase, the enzyme that catalyzes the initial steps in the metabolism of ethylene glycol and methanol to their toxic metabolites
Concurrent use with ethanol is contraindicated because fomepizole is known to prolong the half-life of ethanol.
Opioid OD
Naloxone/naltrexone
Naloxone has an extremely high affinity for μ-opioid receptors in the central nervous system. Naloxone is a μ-opioid receptor competitive antagonist, and its rapid blockade of those receptors often produces rapid onset of withdrawal symptoms.
Benzodiazepines
Flumazenil
Flumazenil competitively inhibits the activity at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex.
TCAs
NaHCO3 (plasma alkanization)
Resolves metabolic acidosis
Heparin
Protamine
Warfarin
Vitamin K, fresh frozen plasma
tPA, streptokinase, urokinase
Aminocaproic acid
Theophylline
Beta-blocker
