Antidotes

Question 1

AChE inhibitors, organophosphates

Answer 1

Atropine followed by pralidoxime

Question 2

Amphetamines overdose

Answer 2

NH4CL (acidfies urine)

Question 3

Antimuscarininc, anticholinergic agent overdose (Atropine)

Answer 3

Physostigmine salicylate (works both peripherally and centrally), control hyperthermia
Common in elderly

Question 4

Benzodiazepines overdose

Answer 4

Flumazenil

Question 5

B-Blockers overdose

Answer 5

Glucagon (acts on Gs and increases intracellular cAMP)

Question 6

Carbon Monoxide poisoning

Answer 6

100% O2, hyperbarid O2

Blocks complex 4 in ETC

Decreasing proton gradient

Question 7

Copper poisoning

Answer 7

Penicillamine or trientine

Question 8

Arsenic poisoining

Answer 8

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

Question 9

Gold poisoning

Answer 9

Pencillamine
Dimercaprol (low therapeutic index can lead to nephrotoxicity and hypertension)
succimer

Question 10

Cyanide poisoining

Answer 10

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

Question 11

Digitalis overdose

Answer 11

Anti-dig Fab fragments

Question 12

Heparin overdose

Answer 12

Protamine sulfate

Question 13

Iron toxicity

Answer 13

Deferoxamine, deferasirox

Question 14

Lead poisoining

Answer 14

EDTA, dimercaprol, succimer, pencillamine

Question 15

Mercury poisoning

Answer 15

Dimercaprol (low therapeutic index can lead to nephrotoxicity and hypertension)
Succimer

Question 16

Methanol, ethylene glycol (antifreeze) poisoning

Answer 16

Fomepizole>ethanol, dialysis

Fomepizole inhibits alcohol dehydrogenase

Question 17

Methemoglobin toxicity

Answer 17

Methylene blue, vitamin C

Question 18

Opioids overdose

Answer 18

Naloxone

Question 19

Salicylates overdose

Answer 19

NaHCO3 (alkalinize urine), dialysis

Question 20

TCAs overdose

Answer 20

NaHCO3 (plasma alkalinization)

Question 21

tPA, streptokinase, urokinase overdose

Answer 21

Aminocaproic acid

Question 22

Warfarin overdose

Answer 22

Vitamin K, plasma (if active bleeding)

Question 23

Rodenticides (brodifarium)

Answer 23

decrease Vitamin K therefore give IV fresh frozen plasma and Vitamin K

Question 24

Acetaminophen overdose

Answer 24

N-acetylcystein (replenishes glutathione)

Also provides sulfylhydryl groups to enhance the non toxic sulfation elimination of acetaminophen

Question 25

Serotonin syndrome

Answer 25

Cryproheptadine | 5HT receptor antagonist

Question 26

Dexrazoxane

Answer 26

Prevents doxorubicin dilated cardiomyopathy by chelating iron decreasing formation of O2 free radicals

Question 27

Amifostone

Answer 27

Prevents cisplatin induced nephrotoxicity Free radical scavenger

Question 28

Leucorvin

Answer 28

"Folinic acid" | Reverses methotrexate myelosuppression because it does not require DHF reductase to be converted to THF

Question 29

Mesna

Answer 29

Partially prevents Hemorrhagic cystitis induced by cyclophosphamide by binding to acrolein which is toxic to uroepithelial cells

Question 30

NE extravasation

Answer 30

Causes a1 receptor vasoconstriction | Treat with phentolamine mesylate an a receptor blocker

Question 31

Rotenone

Answer 31

Blocks Complex 1 in ETC (NADH to NAD+) Decreased proton gradient

Question 32

Antimycin A

Answer 32

Blocks Complex 3 in ETC Decreased proton gradient

Question 33

Oligomycin

Answer 33

Inhibits ATP synthase increased proton gradient

Question 34

2,4 Dinitrophenol

Answer 34

Used illicilty for weight loss Increases permeability of membrane causing decreased proton gradient and increased O2 consumption ETC produces heat not ATP

Question 35

Calcium channel blocker toxicity

Answer 35

Glucagon