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Antidote

Indication

acetylcysteine

Acetaminophen/ Tylenol/

(Mucomyst)

Paracetamol

Activated charcoal

Mode of Action
Restores depleted glutathione
stores and protects against
renal and hepatic failure.

Non-specific poisons

Absorption of drug in the

except cyanide, iron,

gastric and intestinal tracts.

lithium, caustics and

Interrupts the entero-hepatic

alcohol.

cycle with multiple dose.

albuterol inhaler, insulin


& glucose, NaHCO3,

Potassium

kayexalate
anticholinesterase

Neuromuscular blockade

agents

(paralytics)

atropine sulfate or
pralidoxime

Anticholinesterase

Competitive inhibition of
muscarinic receptors.
Not known; partial protection
against acute hepatic failure;

Benzylpenicillin

Amanita phalloides
(Death cap mushroom)

may displace amatoxin from


protein-binding sites allowing
increased renal excretion;
may also inhibit penetration of
amatoxin to hepatocytes.

Calcium salts

Fluoride ingestion

Rapidly complexes with


fluoride ion.
Deferoxamine acts by binding

deferoxamine

Iron

free iron in the bloodstream


and enhancing its elimination
in the urine.
Binds molecules of digoxin,

digibind
digoxine immune fab

Digoxin

making them unavailable for


binding at their site of action
on cells in the body.

dimercapol, edetate

Lead

Chelation of lead ions and

endogenous metals (e.g., zinc,

calcium, disodium,

manganese, iron, copper).

diphenhydramine

Extrapyramidal

(Benadryl)

symptoms (EPS)

A potent antagonist to
acetylcholine in muscarinic
receptors.
Reverses the effects of
benzodiazepines by

flumazenil

Benzodiazepines

competitive inhibition at the


benzodiazepine binding site on
the GABAA receptor.
A competitive inhibitor of the
enzyme alcohol

fomepizole

Ethylene glycol

dehydrogenase found in the


liver. This enzyme plays a key
role in the metabolism of
ethylene glycol and methanol.
Stimulates the formation of
adenyl cyclase causing

glucagon

Beta blockers and

intracellular increase in cycling

calcium channel blockers

AMP and enhanced


glycogenolysis and elevated
serum glucose concentration.
Dextrose (the monosaccharide
glucose) is used, distributed

Glucose (Dextrose 50%)

Insulin reaction

and stored by body tissues


and is metabolized to carbon
dioxide and water with the
release of energy.

Heparin

Ergotamine

Reverses hypercoagulable
state by interacting with
antithrombin III. Used in
combination with vasodilator
phentolamine or nitroprusside
to prevent local thrombosis

and ischemia.
Forms cyanocobalamin, a nonHydroxocobalamin

Cyanide

toxic metabolite that is easily


excreted through the kidneys.

Fluorouracil
Protects the healthy cells from
leucovorin calcium

Methotrexate

the effects of methotrexate


while allowing methotrexate to
enter and kill cancer cells.

Magnesium sulfate

calcium gluconate
A chemoprotectant drug that

mesna

Cyclophosphamide

reduces the undesired effects


of certain chemotherapy
drugs.

Chemical producing
severe
Methylene blue

methemoglobinemia.
Ifosamide-induced

Reduces methemoglobin to
hemoglobin.

encephalopathy.
Prevents or reverses the
nalmefene or naloxone

Opioid analgesics

effects of opioids including


respiratory depression,
sedation and hypotension.
Naloxone is believed to
antagonize opioid effects by

naloxone (Narcan)

Narcotics

competing for the , and


opiate receptor sites in the
CNS, with the greatest affinity
for the receptor.
Anticholinesterase which

Neostigmine

Anticholinergics

causes accumulation of
acetylcholine at cholinergic
receptor sites.

Oxidizes hemoglobin to
methemoglobin which binds
Nitrite, sodium and
glycerytrinitrate

Cyanide

the free cyanide and can


enhance endothelial cyanide
detoxification by producing
vasodilation.

Penicillamine

Copper, gold, lead,


mercury, zinc, arsenic

Chelation of metal ions.


Regitine produces an alphaadrenergic block of relatively
short duration. It also has

phentolamine (Regitine)

Dopamine

direct, but less marked,


positive inotropic and
chronotropic effects on cardiac
muscle and vasodilator effects
on vascular smooth muscle.
A reversible anticholinesterase
which effectively increases the

phyostigmine or NaHCO3

Tricyclic antidepressants

concentration of acetylcholine
at the sites of cholinergic
transmission.

Phytomenadione
(Vitamin K.)

Coumadin/Warfarin

Bypasses inhibition of Vitamin


K epoxide reductase enzyme.
Protamine that is strongly
basic combines with acidic

protamine sulfate

Heparin

heparin forming a stable


complex and neutralizes the
anticoagulant activity of both
drugs.

Pyridoxine

Isoniazid, theophylline,

Reverses acute pyridoxine

monomethyl hydrazine.

deficiency by promoting GABA

Adjunctive therapy in

synthesis. Promotes the

ethylene glycol

conversion of toxic metabolite

poisoning.

glycolic acid to glycine.

Neutralizes venom by binding


with circulating venom
Snake anti-venin

Cobra bite

components and with locally


deposited venom by
accumulating at the bite site.

Iron

Sodium Bicarbonate

Prevents convertion of ferrous


to ferric.

Cardiotoxic drug

Decreases affinity of

affecting fast sodium

cardiotoxic drugs to the fast

channel (TCA, cocaine)

sodium channel.

Weak acids

Promotes ionization of weak


acids.
Neutralization of hydrochloric

Chlorine gas inhalational

acid formed when chlorine gas

poisoning

reacts with water in the


airways.
Replenishes depleted
thiosulphate stores by acting
as sulfur donor necessary for

Sodium thiosulphate

Cyanide

the conversion of CN-O to


thiocyanate through the action
of sulfur transferase enzyme
rhodanese.

Thiamine

Alcohol, Wernicke-

Reverses acute thiamine

Korsakoff Syndrome

deficiency

Adjunctive in ethylene

Enhances detoxification of

glycol

glyoxylic acid.

Chemicals causing
Vitamin C

methemoglobinemia in

Reduces methemoglobin to

patients with G6PD

hemoglobin.

deficiency