Antidotes: Difference between revisions
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{| | {| {{table}} | ||
|- | |- | ||
| | | '''TOXIN''' | ||
TOXIN | | '''ANTIDOTE''' | ||
| ANTIDOTE | |||
|- | |- | ||
| [[ | | [[Acetaminophen]] | ||
| | | | ||
N- | [[N-Acetylcysteine]] | ||
*150mg/kg IV load over 60min; followed by 50mg/kg IV over 4hr and then 100mg/kg IV over 16hr | |||
150mg/kg IV load over 60min; followed by 50mg/kg IV over 4hr and then 100mg/kg IV over 16hr | |||
|- | |- | ||
| | | [[Anticholinergic toxicity|Anticholinergics]] | ||
| | | [[Physostigmine]] | ||
|- | |- | ||
| Arsenic | | [[Arsenic]] | ||
| Dimercaprol (BAL) | | [[Dimercaprol]] (BAL) | ||
|- | |- | ||
| Benzodiazepines | | [[Benzodiazepines]] | ||
| | | | ||
Flumazenil | [[Flumazenil]] | ||
*Adult: 0.2mg IV | |||
Adult: 0.2mg IV | *Peds: 0.01mg/kg IV | ||
Peds: 0.01mg/kg IV | |||
|- | |- | ||
| [[Beta-Blocker Toxicity|Beta blockers]] | | [[Beta-Blocker Toxicity|Beta blockers]] | ||
| | | | ||
Glucagon | [[Glucagon]] | ||
*Adult: 3-10mg IV | |||
Adult: 3-10mg IV | *Peds: 50-150mcg/kg IV | ||
Peds: 50-150mcg/kg IV | |||
|- | |- | ||
| [[Calcium Channel Blocker Toxicity|Ca channel blockers]] | |||
| | | | ||
[[Calcium | [[Calcium chloride]] 10% | ||
*Adult: 10 mL IV | |||
*Peds: 0.2-0.25 mL/kg IV | |||
High Dose Insulin (1 unit/kg/hr) | |||
|- | |||
| [[Clonidine Toxicity|Clonidine]] | |||
| | | | ||
[[Naloxone]] | |||
*Adult: 0.4-2mg IV | |||
Adult: | *Peds: 0.1mg/kg IV (max 2mg) | ||
Peds: 0. | |||
|- | |- | ||
| [[Cyanide]] | |||
| | | | ||
[[Hydroxocobalamin]] | |||
'''OR''' | |||
[[Cyanokit]] (Amyl Nitrite, Sodium Nitrite, and Sodium Thiosulfate) | |||
|- | |- | ||
| [[ | | [[Dabigatran]] | ||
| | | [[Idarucizumab]] 5mg IV | ||
|- | |- | ||
| [[Digoxin Toxicity|Digoxin]] | | [[Digoxin Toxicity|Digoxin]] | ||
| [[Dig Immune Fab]] | | [[Dig Immune Fab]] | ||
|- | |- | ||
| [[Ethylene Glycol Poisoning|Ethylene glycol]] | | [[Ethylene Glycol Poisoning|Ethylene glycol]] | ||
| | | | ||
Fomepizole | [[Fomepizole]] | ||
*15mg/kg IV; then 10mg/kg q12h | |||
|- | |||
| Factor Xa Inhibitor (e.g. [[apixaban]], [[rivaroxaban]] | |||
| [[Andexanet alfa]] | |||
4-factor [[PCC]] | |||
|- | |- | ||
| Fluoride | | Fluoride | ||
| Calcium | | [[Calcium gluconate]] | ||
|- | |- | ||
| [[Heparin (Unfractionated)|Heparin]] | | [[Heparin (Unfractionated)|Heparin]] | ||
| | | | ||
Protamine | [[Protamine sulfate]] | ||
*Adult: 25-50mg IV (empiric dose) over 10 minutes | |||
Adult: 25-50mg IV (empiric dose) | *Peds: 0.6mg/kg IV (empiric dose) | ||
Peds: 0.6mg/kg IV (empiric dose) | |||
''Note: Rapid protamine infusion causes hypotension''<ref>Hirsh J. et al. "Parenteral anticoagulants: ACCP Evidence-Based Clinical Practice Guidelines. Chest 2008; 133</ref> | |||
|- | |- | ||
| [[Iron (Fe)|Iron]] | | [[Iron (Fe)|Iron]] | ||
| Deferoxamine | | [[Deferoxamine]] | ||
|- | |- | ||
| Isoniazid (INH) | | [[Isoniazid]] (INH) | ||
| | | | ||
Pyridoxine (Vit B6) | [[Pyridoxine]] (Vit B6) | ||
*Adult: 5gm IV | |||
Adult: 5gm IV | *Peds: 1gm/kg regardless of age <ref>Minns, A. et al. Isoniazid-Induced Status Epilepticus in a Pediatric Patient After Inadequate Pyridoxine Therapy. Pediatric Emergency Care. 2010:26(5)380-381</ref> | ||
Peds: | |||
|- | |- | ||
| Lead | | [[Lead toxicity|Lead]] | ||
| EDTA, succimer | | [[EDTA]], [[succimer]] | ||
|- | |- | ||
| Mercury | | [[Mercury Poisoning|Mercury]] | ||
| Dimercaprol (BAL) | | [[Dimercaprol]] (BAL) | ||
|- | |- | ||
| Methanol | | [[Methanol Toxicity|Methanol]] | ||
| Fomepizole | | | ||
[[Fomepizole]] | |||
*15mi/kg IV; then 10mg/kg q12h<br> | |||
|- | |- | ||
| | | [[Methemoglobinemia]] | ||
| Methylene blue | | [[Methylene blue]] | ||
|- | |- | ||
| [[ | | [[Methotrexate toxicity]] | ||
| | | [[Glucarpidase]] | ||
|- | |- | ||
| [[ | | [[Opioid Overdose|Opioids]] | ||
| | | [[Naloxone]] | ||
|- | |- | ||
| Sulfonylurea | | [[Organophosphates]] | ||
| [[Atropine]] + [[Pralidoxime]] | |||
|- | |||
| [[Sulfonylurea Toxicity|Sulfonylurea]] | |||
| | | | ||
Octreotide | [[Octreotide]] | ||
*Adult: 50–100mcg SC q6hr | |||
Adult: 50–100mcg SC q6hr | *Peds: 1mcg/kg SC q6hr | ||
Peds: 1mcg/kg SC q6hr | |||
|- | |- | ||
| Valproate | | [[Tricyclic (TCA) Toxicity]] | ||
| | | | ||
[[Bicarbonate]] | |||
*1-2mEq/kg IV bolus followed by 2mEq/kg/hr IV infusion | |||
|- | |||
| [[Valproic acid toxicity|Valproate]] | |||
| [[L-carnitine]] | |||
|- | |- | ||
| [[Warfarin (Coumadin) Reversal|Warfarin]] | | [[Warfarin (Coumadin) Reversal|Warfarin]] | ||
| | | [[Vitamin K]], [[Fresh Frozen Plasma|FFP]], [[Prothrombin complex concentrate]] | ||
|} | |} | ||
== | ==References== | ||
<references> | |||
[[Category: | [[Category:Toxicology]] | ||
Latest revision as of 20:45, 22 September 2019
| TOXIN | ANTIDOTE |
| Acetaminophen |
|
| Anticholinergics | Physostigmine |
| Arsenic | Dimercaprol (BAL) |
| Benzodiazepines |
|
| Beta blockers |
|
| Ca channel blockers |
Calcium chloride 10%
High Dose Insulin (1 unit/kg/hr) |
| Clonidine |
|
| Cyanide |
Hydroxocobalamin OR Cyanokit (Amyl Nitrite, Sodium Nitrite, and Sodium Thiosulfate) |
| Dabigatran | Idarucizumab 5mg IV |
| Digoxin | Dig Immune Fab |
| Ethylene glycol |
|
| Factor Xa Inhibitor (e.g. apixaban, rivaroxaban | Andexanet alfa
4-factor PCC |
| Fluoride | Calcium gluconate |
| Heparin |
Note: Rapid protamine infusion causes hypotension[1] |
| Iron | Deferoxamine |
| Isoniazid (INH) |
Pyridoxine (Vit B6)
|
| Lead | EDTA, succimer |
| Mercury | Dimercaprol (BAL) |
| Methanol |
|
| Methemoglobinemia | Methylene blue |
| Methotrexate toxicity | Glucarpidase |
| Opioids | Naloxone |
| Organophosphates | Atropine + Pralidoxime |
| Sulfonylurea |
|
| Tricyclic (TCA) Toxicity |
|
| Valproate | L-carnitine |
| Warfarin | Vitamin K, FFP, Prothrombin complex concentrate |
References
<references>