Antidotes (7) Flashcards
Naloxone
Brand Name: Narcan
Classification: Opiate Antagonist
Action: Opioid antagonist without opiate agonist properties (it has not activity when given in the absence of an opiate agonist
Indications: Partial reversal of opiate drug effects, Opiate overdose
Contraindications: Hypersensitivity
Dose: 0.4-2.0 mg
Routes: IV, IO, SQ, IN, Nebulizer
Adverse Effects: Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal
Other: Administer enough to reverse respiratory depression and avoid full narcotic withdrawal
Flumazenil
Brand Name: Romazicon
Classification: benzodiazepine antagonist
Action: Competitively blocks benzodiazepines at the GABA/benzodiazepine receptor complex
Indications: Overdose of Benzodiazepines
Contraindications: Hypersensitivity, Patient taking Benzodiazepine for a life-threatening illness
Dose: 0.2 mg Additional 0.3 mg may be given 30 sec later. Later doses of 0.5 mg may be given at 1 min intervals max dose of 3 mg
Routes: IV
Adverse Effects: fatigue, headache, nervousness, dizziness
Other: Admin with caution in pts dependent on benzodiazepines as life-threatening withdrawal (including seizures) can occur
Hydroxocobalamin
Brand Name: Cyanokit
Classification: cyanide antidote
Action: chelates cyanide from cytochrome oxidase forming cyanocobalamin (Vitamin B12)
Indications: cyanide or suspected cyanide poisoning
Contraindications: none in the emergency setting
Dose: 5-10mg
Routes: IV
Adverse: Chromaturia, red skin, rash, hypertension, nausea, headache
Other: Be prepared to continue full resuscitative measures following administration
Amyl Nitrite
Brand Name: Amyl nitrite
Classification: Cyanide antidote
Action: Vasodilator; oxidizes hemoglobin to methemoglobin which reacts with cyanide ion to form cyanmethemoglobin, that is enzymatically degraded
Indications: Cyanide poisoning
Contraindications: None in the emergency setting
Dose: 1-2 inhalants
Routes: Inhaled
Adverse Effects: Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension
Other: Headache and hypotension common, can worsen hypoxia in the setting of CO poisoning
Sodium Nitrite
Brand Name: Sodium Nitrite
Classification: Cyanide Antidote
Action: Vasodilator; oxidizes to hemoglobin to methemoglobin which reacts to cyanide ion to form cyanomethemoglobin, which is enzymatically degraded
Indications: cyanide poisoning
Contraindications: should not be administered to asymptomatic pts
Dose: 150-300 mg
Routes: IV
Adverse: Headache, weakness, dizziness, flushing, tachycardia, orthostatic hypotension
Other: Headache and hypotension common; can worsen hypoxia in the setting of carbon monoxide poisoning
Sodium Thiosulfate
Brand Name: Sodium Thiosulfate
Classification: Cyanide antidote
Action: converts cyanide to thiocyanate, which is removed by the kidneys
Indications: cyanide poisoning
Contraindications: none in the emergency setting
Dose: 12.5g
Routes: IV
Adverse: Nausea, vomiting, joint pain, psychosis
Other: should be administered as part of the standard (Pasadena) cyanide kit
Pralidoxime
Brand Name: 2-PAM, Protpam
Classification: Organophosphate antidote
Action: Reactivates cholinesterase; deactivates certain organophosphates
Indications: organophosphate poisoning
Contraindications: poisoning other than organophosphates
Dose: 1-2g over 30 min
Routes: IV
Adverse: Excitement, manic behavior, laryngospasm, tachycardia
Other: Always protect rescue personnel from the poison; 2-PAM administration should always follow atropinization
