Pharm Toxicities/Antidotes

Question 1

acetominophen

Answer 1

N-acetylcysteine (replenish glutathione by acting like it)

Question 2

salicylates

Answer 2

• NaHCO3 (alkalinazines urine)

- dialysis (if high dose)

Question 3

amphetamines (basic)

Answer 3

NH4Cl (acidify urine)

Question 4

AChE inhibitors, organophosphates

Answer 4

atropine, pralidoxime

Question 5

anti-muscarinic, anti-cholinergic agents

Answer 5

physostigmine salicylate, control hyperthermia

Question 6

beta-blockers

Answer 6

glucagon (increases cAMP in myocardium)

Question 7

digitalis

Answer 7

Normalize K, lidocaine, anti-dig Fab fragments, Mg

can give atropine too

Question 8

Iron

Answer 8

deferoxamine - binds iron in body + facilitates its urinary excretion
deferasirox
(mneumonic - both have FE in them)

Question 9

lead

Answer 9

CaEDTA - forms complexes w/ mono, di, trivalent ions
dimercaprol
succimer
penicillamine

Question 10

mercury, arsenic, gold

Answer 10

dimercaprol (BAL) - displaces arsenic ions from sulfhydryl groups of enzymes; SE = nephrotox + HTN
succimer

Question 11

copper, arsenic, gold

Answer 11

penicillamine

Question 12

cyanide

Answer 12

nitrate + thiosulfate (thiosulfate transfers sulfur to form thiocyanate), hydroxocobalamin
amyl nitrate - forms methemoglobin that binds CN forming non-toxic compound cyanomethemoglobin

Question 13

methemoglobin

Answer 13

methylene blue - converts iron in heme from Fe3+ to Fe2+ state
vit C

Question 14

carbon monoxide

Answer 14

100% oxygen, hyperbaric O2

Question 15

methanol, ethylene glycol (antifreeze)

Answer 15

fomepizole (DOC) > ethanol, dialysis

Question 16

opioids

Answer 16

naloxone/naltrexone

Question 17

benzodiazepines

Answer 17

flumazenil

Question 18

TCAs

Answer 18

NaHCO3 (plasma alkalinization)

Question 19

heparin

Answer 19

protamine

Question 20

warfarin

Answer 20

vit K, fresh frozen plasma

Question 21

tPA, streptokinase, urokinase

Answer 21

• aminocaproic acid

- transexamic acid (inhibs fibrinolysis)

Question 22

theophylline

Answer 22

see: arrhythmia, seizures, tachycardia
tx:
- beta-blocker
- activated charcoal (decreases absorption)