Analgesic Poisoning
Poison: Salicylate Overdose (Salicylism)
Antidote:
a. Alkalinize Urine with Sodium Bicarbonate
b. Consider Dialysis
Poison: Acetaminophen Overdose
Antidote: N-Acetylcysteine (NAC, Mucomyst, PO or Neb, Acetadote IV) based on nomogram
Poison: Opioid Overdose (Narcotic Overdose)
Antidote: Naloxone
Cardiovascular Agent Poisoning
Poison: Beta Blocker Overdose & Calcium Channel Blocker Overdose
Antidote:
a. Gastric Decontamination
b. Epinepherine
c. Glucagon
d. Calcium Replacement
e. Sodium Bi-Carbonate
f. Insulin Euglycemia protocol
g. Methylene blue
Poison: Digoxin
Antidote: Digoxin Immune Fab fragments (Digibind)
Psychiatric Agents Poisoning
Poison: Benzodiazepine Overdose
Antidote: Flumazenil (risk of Seizure if chronic daily Benzodiazepine use)
Poison: Serotonin Syndrome
Antidote: Cyproheptadine
Poison: Tricyclic Antidepressants Overdose
Antidote:
a. Sodium Bicarbonate to alkalinize the urine
b. Benzodiazepines for Seizure (avoid other anticonvulsants)
Heavy Metal and Metal Poisoning
Poison: Arsenic
Antidote: British Anti-Lewisite (BAL) Chelation or Dimercaprol
Poison: Iron
Antidote: Deferoxamine (Desferal)
Poison: Lead
Antidote:
a. Dimercaptosuccinic acid (DMSA, Succimer or Chemet)
b. Ethylenediaminetetraacetic acid (EDTA)
Poison: Mercury
Antidote: Dimercaptosuccinic acid (DMSA, Succimer or Chemet)
Agents interfering with Oxygenation
Poison: Carbon Monoxide
Antidote:
a. Oxygen
b. Hyperbaric chamber
Poison: Cyanide
Antidote:
a. Nitrites (Cyanokit, Sodium nitrite, Sodium thiosulfate)
b. Hydroxycobalamin (B12 analogue)
c. Oxygen
Poison: Methemoglobinemia
Antidote: Methylene blue
Parasympathetic Poisoning
Poison: Anticholinergics
Antidote: Physostigmine
Poison: Organophosphates or Cholinergic Poisoning
Antidote:
a. Atropine
b. Pralidoxime (2-PAMCl)
Miscellaneous Poisoning
Poison: Fluoride
Antidote: Calcium
Poison: Hydrazines
Antidote: Pyridoxine
Poison: Isoniazid (INH)
Antidote: Pyridoxine
Poison: Methanol or Ethylene Glycol
Antidote:
a. Fomepizole (Antizol)
b. Ethanol 10%
Poison: Oxalates
Antidote: Calcium
Poison: Hydrofluoric Acid
Antidote:
a. Risk of severe Hypocalcaemia and Hypomagnesaemia in even minimal exposures
b. Calcium Gluconate 2.5% gel applied to area
c. Calcium Gluconate 5% solution may also be injected into the region of contact
Poison: Sulfonylurea
Antidote:
a. See Sulfonylurea Overdose
b. Octreotide (Sandostatin)
c. Dextrose
d. Glucagon (temporizing measure only)
Poison: Valproic Acid
Antidote: Carnitine
Poison: Warfarin
Antidote:
a. Vitamin K
b. Fresh Frozen Plasma
c. Prothrombin Complex Concentrate 4 (PCC4)
Drugs and Their Antidote: Click Here
