Ch. 20: Emergency Preparedness Flashcards
Benzodiazepine Antidote
Flumazenil (Romazicon)
Cyanide Antidote
Hydroxocobalamin (Cyanokit)
Nitroprusside Antidote
Sodium thiosulfate and sodium nitrite (Nithiodote)
Ethanol Antidote
Thiamine (B1)
5-FU, capecitabine
Uridine triacetate (Vistogard, Xuriden)
Arsenic, Gold, Mercury (or lead in conjunction with calcium disodium edetate) Antidote
Dimercarpol
Copper Antidote
Penicillamine
Lead Antidote
Succimer (Chemet), DMSA
Thallium Antidote
Ferric hexacyanoferrate (Prussian Blue) Radiogardese
Sulfonylurea Antidote
Octreotide (SandoStatin)
Ethylene Glycol (Antifreeze), Diethylene glycol, Methanol Antidote
Fomepizole (Antizol) 1st line
Ethanol (2nd line)
Isoniazid Antidote
Pyridoxine (B6), BZDs, and/or barbiturates
Iron Antidote
Desferoxamine (Desferal), deferiprone (Ferriprox), deferasirox (Exjade, Jadenu)
Organophosphate Antidote
Atropine and pralidoxine or in combo (Duodote, ATNAA)
MTX Antidote
Leucovorin (folinic acid), levoleucovorin (Fusilev), glucardipase (Voraxaze)
Methemoglobinurea Antidote
Methylene blue (ProvayBlue); CI in G6PD deficiency
Mushrooms (amatoxin-containing) Antidote
Silibirin (Legalon SIL), Atropine (if bradycardia)
Napthalene (mothballs) Antidote
Methylene Blue (ProvayBlue)
Neostigmine, Pyridostigmine Antidote
Pralidoxime (Protopam)
Nicotine Antidote
Atropine (if bradycardia present)
Petroleum Distillates (gasoline, kerosene, mineral oil, paint thinners) Antidote
Do not induce vomiting, keep NPO to prevent aspiration
Rocuronium, Vercuronium, Pancuronium Antidote
Neostigmine (Bloxiverz)
Rocuronium, Vercuronium Antidote
Sugammadex (Bridion)
Salicylate Antidote
Sodium bicarbonate
Stimulants (Amphetamines-ADHD and weight loss, cocaine, ephedrine, caffeine, Theophylline, MDMA) Antidote
BZDs if agitation of seizures
TCA Antidote
Sodium Bicarbonate: decrease a widened QRS complex
BZDs: if agitation of seizures present
Vasopressors: for hypotension
Valproate or Topiramate induced hyperammonemia
Levocarnitine (Carnitor)
Oral NAC Product and Dosing
Cetylev Effervescent Tablets, Mucomyst
140mg/kg x 1 dose followed by 70mg/kg Q4h x 17 additional doses
IV NAC Product and Dosing
Acetadote IV
150mg/kg IV over 60 minutes, followed by 50mg/kg IV over 4 hours, followed by 100 mg/kg over 16 hours
Warfarin and Xa Inhibitor Antidote
Prothrombin Complex Concentrate (KCentra)
Heparin Antidote
Protamine (1mg=100u of heparin reversal)
Direct Thrombin Inhibitor (Pradaxa) Antidote
Idarucizumab (Praxbind)
Digoxin Antidote
Digoxin Immune Fab (DigiFab)
40 mg vials bind ~0.5 mg of Digoxin
Max adult dose: 20 vials
Anticholinergic Overdose Sxs
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
Animal Bite Antidote
Rabies vaccine (RabAvert, ImovaxRabies) WITH Human rabies immune globulin (HyperRAB S/D, Imogam Rabies HT)
Black Widow Spider Bite Antidote
Antiverin for Lactrodectus mactans
Scorpion Sting Antidote
Antivenin immune FAB Centruroides (Anascorp)
Snake Bites: eastern coral snake, Texas coral snake, copperhead snake, rattle snake Antidote
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
Atropine can be given as an antidote/sx control in:
Organophosphate Poisoning
Mushrooms-if bradycardia present
Nicotine-if bradycardia present
Neostigmine-give before to prevent bradycardia
BZDs can be given for sx management in:
Isoniazid
Local anesthetics (bupivacaine, mepivacaine, ropivacaine) and with other lipophilic drugs
Nicotine
Stimulant overdose
