Pharmacology: Antidotes Flashcards

1
Q

Acetaminophen toxicity

What is the MOA?

A

N-acetylcysteine (replenishes glutathione)

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2
Q

Salicylate toxicity

A

NaHCO3 (alkalinize urine)

Dialysis

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3
Q

Amphetamines (basic) toxicity

A

NH4Cl (acidify urine)

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4
Q

Acetylcholinesterase inhibitor toxicity

A

Atropine (reverse mACh sx, but not nACh effects–muscle paralysis)
Pralidoxime (affects both m- and n-ACh sx)

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5
Q

Organophosphate toxicity

A

Atropine (anti-ACh; reverse mACh sx, but not nACh effects–muscle paralysis)
Pralidoxime (affects both m- and n-ACh sx)

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6
Q

Antimuscarinic, anticholinergic toxicity

A

Pysostigmine salicylate

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7
Q

Beta-blocker overdose

A

Glucagon (increase of cAMP in the myocardium, in effect bypassing the β-adrenergic second messenger system)

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8
Q

Digitalis toxicity - “yellow vision” with yellow/green halos, bradycardia, prolonged PR

A

Stop dig. Anti-dig Fab fragments (binds dig)

Treat arrythmias: normalize K+, give Lidocaine, Mg2+

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9
Q

Iron

A

Deferoxamine (Fe chelator)

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10
Q

Lead

A

CaEDTA
Dimercaprol (BAL)
Succimer (dimercaptosuccinic acid)
Penicillamine

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11
Q

Mercury

A

CaEDTA
Dimercaprol (BAL)
Succimer (dimercaptosuccinic acid)

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12
Q

Arsenic

A

Chelators:
Dimercaprol (BAL)
Succimer (dimercaptosuccinic acid)
Penicillamine

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13
Q

Gold

A

Chelators:
Dimercaprol (BAL)
Succimer (dimercaptosuccinic acid)
Penicillamine

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14
Q

Copper

A

Penicillamine

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15
Q

Cyanide

A

Amyl nitrite: oxidant, induces the formation of metHb. mHb in turn can sequester cyanide as cyanomethemoglobin.
Hydroxocobalamin (B12): binds CN-
Sodium thiosulfate: donating additional sulfur to liver rhodanase to enhance metabolism and detox CN- to thioctyanate

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16
Q

Methemoglobin

A
Methylene blue (reducing agent)
Vitamin C
17
Q

Carbon monoxide poisoning

A

100% O2, hyperbaric O2

18
Q

Methanol, ethylene glycol (antifreeze)

A

Fomepizole > ethanole, dialysis

19
Q

Opiods: overdose vs. dependence

A

Naloxone (overdose): opioid inverse AGonist
Naltrexone (dependence): opiod ANtagonist, block euphoric effects

Naltrexone should not be confused with naloxone (which is used in emergency cases of opioid overdose). Using naloxone in place of naltrexone can cause acute opioid withdrawal symptoms; conversely, using naltrexone in place of naloxone in an overdose can lead to insufficient opioid antagonism and fail to reverse the overdose.

20
Q

Benzodiazepines

A

Flumazenil

21
Q

TCAs

A

NaHCO3 (plasma alkalinization)

22
Q

Heparin

A

Protamine

23
Q

Warfarin

A

Vitamin K, FFP

24
Q

tPA, streptokinase, urokinase

A

Aminocaproic acid (inhibits plasmin)

25
Q

Theophylline

A

Beta-blocker

Methylxanthine, for asthma, COPD. Competitive nonselective phosphodiesterase inhibitor, which raises intracellular cAMP, activates PKA, inhibits TNF-alpha and inhibits leukotriene synthesis, and reduces inflammation and innate immunity
nonselective adenosine receptor antagonist, antagonizing A1, A2, and A3 receptors almost equally, which explains many of its cardiac effects

26
Q

Amyl nitrate

A

For CN- toxicity

Oxidant, induces the formation of methemoglobin. Methemoglobin in turn can sequester cyanide as cyanomethemoglobin.

27
Q

Sodium thiosulfate

A

donating additional sulfur to liver rhodanase to enhance metabolism and detox CN- to thioctyanate