Ch. 20: Emergency Preparedness

Question 1

Benzodiazepine Antidote

Answer 1

Flumazenil (Romazicon)

Question 2

Cyanide Antidote

Answer 2

Hydroxocobalamin (Cyanokit)

Question 3

Nitroprusside Antidote

Answer 3

Sodium thiosulfate and sodium nitrite (Nithiodote)

Question 4

Ethanol Antidote

Answer 4

Thiamine (B1)

Question 5

5-FU, capecitabine

Answer 5

Uridine triacetate (Vistogard, Xuriden)

Question 6

Arsenic, Gold, Mercury (or lead in conjunction with calcium disodium edetate) Antidote

Answer 6

Dimercarpol

Question 7

Copper Antidote

Answer 7

Penicillamine

Question 8

Lead Antidote

Answer 8

Succimer (Chemet), DMSA

Question 9

Thallium Antidote

Answer 9

Ferric hexacyanoferrate (Prussian Blue) Radiogardese

Question 10

Sulfonylurea Antidote

Answer 10

Octreotide (SandoStatin)

Question 11

Ethylene Glycol (Antifreeze), Diethylene glycol, Methanol Antidote

Answer 11

Fomepizole (Antizol) 1st line

Ethanol (2nd line)

Question 12

Isoniazid Antidote

Answer 12

Pyridoxine (B6), BZDs, and/or barbiturates

Question 13

Iron Antidote

Answer 13

Desferoxamine (Desferal), deferiprone (Ferriprox), deferasirox (Exjade, Jadenu)

Question 14

Organophosphate Antidote

Answer 14

Atropine and pralidoxine or in combo (Duodote, ATNAA)

Question 15

MTX Antidote

Answer 15

Leucovorin (folinic acid), levoleucovorin (Fusilev), glucardipase (Voraxaze)

Question 16

Methemoglobinurea Antidote

Answer 16

Methylene blue (ProvayBlue); CI in G6PD deficiency

Question 17

Mushrooms (amatoxin-containing) Antidote

Answer 17

Silibirin (Legalon SIL), Atropine (if bradycardia)

Question 18

Napthalene (mothballs) Antidote

Answer 18

Methylene Blue (ProvayBlue)

Question 19

Neostigmine, Pyridostigmine Antidote

Answer 19

Pralidoxime (Protopam)

Question 20

Nicotine Antidote

Answer 20

Atropine (if bradycardia present)

Question 21

Petroleum Distillates (gasoline, kerosene, mineral oil, paint thinners) Antidote

Answer 21

Do not induce vomiting, keep NPO to prevent aspiration

Question 22

Rocuronium, Vercuronium, Pancuronium Antidote

Answer 22

Neostigmine (Bloxiverz)

Question 23

Rocuronium, Vercuronium Antidote

Answer 23

Sugammadex (Bridion)

Question 24

Salicylate Antidote

Answer 24

Sodium bicarbonate

Question 25

Stimulants (Amphetamines-ADHD and weight loss, cocaine, ephedrine, caffeine, Theophylline, MDMA) Antidote

Answer 25

BZDs if agitation of seizures

Question 26

TCA Antidote

Answer 26

Sodium Bicarbonate: decrease a widened QRS complex BZDs: if agitation of seizures present Vasopressors: for hypotension

Question 27

Valproate or Topiramate induced hyperammonemia

Answer 27

Levocarnitine (Carnitor)

Question 28

Oral NAC Product and Dosing

Answer 28

Cetylev Effervescent Tablets, Mucomyst | 140mg/kg x 1 dose followed by 70mg/kg Q4h x 17 additional doses

Question 29

IV NAC Product and Dosing

Answer 29

Acetadote IV | 150mg/kg IV over 60 minutes, followed by 50mg/kg IV over 4 hours, followed by 100 mg/kg over 16 hours

Question 30

Warfarin and Xa Inhibitor Antidote

Answer 30

Prothrombin Complex Concentrate (KCentra)

Question 31

Heparin Antidote

Answer 31

Protamine (1mg=100u of heparin reversal)

Question 32

Direct Thrombin Inhibitor (Pradaxa) Antidote

Answer 32

Idarucizumab (Praxbind)

Question 33

Digoxin Antidote

Answer 33

Digoxin Immune Fab (DigiFab) 40 mg vials bind ~0.5 mg of Digoxin Max adult dose: 20 vials

Question 34

Anticholinergic Overdose Sxs

Answer 34

Red as beet: flushing Dry as a bone: dry skin and mucous membranes Blind as a bat: mydriasis with double or blurry vision Mad as a hatter: altered mental status Hot as a hare: fever

Question 35

Animal Bite Antidote

Answer 35

``` Rabies vaccine (RabAvert, ImovaxRabies) WITH Human rabies immune globulin (HyperRAB S/D, Imogam Rabies HT) ```

Question 36

Black Widow Spider Bite Antidote

Answer 36

Antiverin for Lactrodectus mactans

Question 37

Scorpion Sting Antidote

Answer 37

Antivenin immune FAB Centruroides (Anascorp)

Question 38

Snake Bites: eastern coral snake, Texas coral snake, copperhead snake, rattle snake Antidote

Answer 38

Crotalidae polyvalent immune FAB (CroFab) for copperhead and rattlesnake bites Antivenin Micrurus fulvius for coral snake bites Crotalidae Immune F(ab')2 (Anavip) for rattlesnake bites

Question 39

Atropine can be given as an antidote/sx control in:

Answer 39

Organophosphate Poisoning Mushrooms-if bradycardia present Nicotine-if bradycardia present Neostigmine-give before to prevent bradycardia

Question 40

BZDs can be given for sx management in:

Answer 40

Isoniazid Local anesthetics (bupivacaine, mepivacaine, ropivacaine) and with other lipophilic drugs Nicotine Stimulant overdose