Pharm Drug Antidotes (from DIT)

Question 1

acetaminophen (hepatotoxocity)

Answer 1

N-Acetylcysteine (replenish NAPQI)
(nrm path:
acetaminophen -> NAPQI -> glutathione -> excrete safe matabolites) or else (NAPQI will take to hepatotoxicity path)

Question 2

salicylates (ASA)

Answer 2

sodium bicarbonate

Question 3

amphetamines

Answer 3

ammonium chloride

Question 4

anticholinesterases, organophosphates “leaky”

Answer 4

(acute/sx) - atropine

(LT AchE regen) - pralidoxine

Question 5

antimuscarinic, anticholinergic agents “dry, bloated”

OD by atropine

Answer 5

physostigmine

Question 6

digoxin (OD = arrhythmia)

Answer 6

K+ and Mg2+ optonmization

atropine, anti-dig fragments

Question 7

iron (GI, N/V) “fe”

Answer 7

deferoxamine

de”fe”roxamine

Question 8

lead (developmental delay, GI)

Answer 8

dimercaprol, EDTA, succimer

Question 9

copper, arsenic, gold

Answer 9

penicillamine (copper, gold)

dimercaprol (arsenic gold)

Question 10

cyanide (inhibit cyt c oxidase) - commonly occurs with patients treated for hypertensive emergency with nitroprusside -> metab into nitrate and cyanide ions

Answer 10

hydroxocalbumin (directly binds cyanide ions), thiosulfate (detoxifying sulfur donors), nitrates (makes methemaglobinemia)

Question 11

methemoglobin (decrease RBC release oxygen to tissue)

Answer 11

methylene blue, vit C

Question 12

carbon monoxide “cherry red lips”

Answer 12

100% oxygen, hyperbaric oxygen

Question 13

methanol, ethylene glycole (antifreeze)

Answer 13

fomepizole, ethanol (competitive inhibit), dialysis

Question 14

opioids “pin-point pupils”

Answer 14

naloxone (short half-life), naltrexone

Question 15

benzodiazepines

Answer 15

flumazenil (rapid use = seizure risk), supportive

Question 16

TCAs

Answer 16

sodium bicarb

Question 17

heparin

Answer 17

protamine sulfate

“H+”, proton = “P+”

Question 18

warfarin

Answer 18

vit K (slow), fresh frozen plasma (acute tx with clotting factors)

Question 19

t-PA, streptokinase, urokinase

Answer 19

aminocaproic acid

Question 20

theophylline (causes tachycardia)

Answer 20

b-blocker

Question 21

B-blockers, verapamil

Answer 21

glucagon, atropine, calcium (will increase HR)

Question 22

arsenic, mercury, gold

Answer 22

dimercaprol, succimer
(dime = unit of money = gold)
(“merc” = mercury)