Antidotes Flashcards
AChE inhibitors, organophosphates
Atropine followed by pralidoxime
Amphetamines overdose
NH4CL (acidfies urine)
Antimuscarininc, anticholinergic agent overdose (Atropine)
Physostigmine salicylate (works both peripherally and centrally), control hyperthermia Common in elderly
Benzodiazepines overdose
Flumazenil
B-Blockers overdose
Glucagon (acts on Gs and increases intracellular cAMP)
Carbon Monoxide poisoning
100% O2, hyperbarid O2
Blocks complex 4 in ETC
Decreasing proton gradient
Copper poisoning
Penicillamine or trientine
Arsenic poisoining
pencillamine
Dimercaprol depletes aresenic from sulfhydryl groups of enzymes (low therapeutic index can lead to nephrotoxicity and hypertension)
Succimer
Aresenic inhibits lipoic acid (cofactor for a ketodehydrogenase and pyruvate dehydrogenase)-vomiting, rice water stools and garlic breath
Causes 0 net ATP in glycolysis
Gold poisoning
Pencillamine
Dimercaprol (low therapeutic index can lead to nephrotoxicity and hypertension)
succimer
Cyanide poisoining
Can be due to nitroprusside overdose
Nitrite+thiosulfate,
hydroxocobalamin (directly binds to cyanide)
Cyanide inhibits cytochrome a-a3 complex in ETC inhibiting aerobic metabolism-decreases proton gradient
Cyanide normally broken down by rhodanese a sulfur donor that converts cyanide to thiocyanate which can be excreted in the urine
Nitrite increase methemoglobin which cannot bind oxygen but has an increased affinity for cyanide therefore cyanide is sequestered in blood away from mitochondria
Digitalis overdose
Anti-dig Fab fragments
Heparin overdose
Protamine sulfate
Iron toxicity
Deferoxamine, deferasirox
Lead poisoining
EDTA, dimercaprol, succimer, pencillamine
Mercury poisoning
Dimercaprol (low therapeutic index can lead to nephrotoxicity and hypertension)
Succimer