Toxicity

Antidote
X

Barbiturate
Benzodiazepin

Anti Depressant
noncyclic

Anti Depressant
tricyclic

Amphetamine

Cannabis ,
Marjuana

Methanol

Flumazenil 0.1-0.2 mg I.V

Max :3mg ( drawback: side
sever effect )

For suspected serotonin

syndrome
- Cyproheptadine 4mg PO
every hr for 3doses
- Methysergid 2mg PO
every hr for 3doses
- QRS interval prolongation
sodium bicarbonate 1-2
mEq/kg
- Hyperventilation induce
respiratory alkalosis
- Physostigmine used in
past but withdraw for
sever side effect
X
Agitation : Diazepam 10 mg
I.V
HTN: Phentolamine
X
Physiological disturbance :
Use : lorazepam , diazepam
Bicarbonate 400-600 mmol
during first hrs (reserve
visual impairment)
1ml/kg of 5fold diluted
alcohol 96%
0.16ml/kg/hr maintenance

Decontamination

Elimination

AC (1g/kg) ,
MDAC (15-20g ever
6h)
AC (chance of
aspiration so protect
airway ),
Gastric emptying may
useful

+ Alkalinization (PH > 7.5

) only in phenobarbital

AC , do not induce
emesis

X
(Extensive protein binding ,
large volume distribution)

AC , do not induce
emesis
Gastric lavage for
large ingestion 2030mg/kg

AC , do not induce
emesis
AC , Ipecac induced
vomiting
May be useful
(prehospital)

Ethanol

X
(EPB,LVD)

X , renal elimination by
acidification of urine but not
recommended due to
nephrotoxicity
X

(LVD)

Haemodialysis
X

dose oraly

Fomepizole : 15mg/kg
loading dose
10mg/kg 4bolus
every 12hrs
Abnormal mental status
glucose 25-50g , Naloxone
2mg , Thiamine 100mg

Folic acid/ Folinic acid

50mg I.V every 4hrs for
24hrs
Magnesium

Gastric lavage

Haemodialysis
(but invasive procedure)

Cocaine

Salicylate
(aspirin)

Seizures lorazepam 2mg

Disulfiram : 12hr before off
alcohol
Orally 250500mg/day
Acamprosate : 666mg/d
3doses
X
HTN: phentolamine
HTN, Agitation :Dizepam 510mg
MI: diazepam,aspirin 325mg
,nitroglycerin 0.4 mg SL
Phentolamaine :1-5mg I.V

In case of
Ethanol ingestion
1g/kg
Or co-ingestant
suspected

AC , do not induce
emesis

Not routinely recommended

Whole-bowel
irrigation , cocainefilled candoms
ingestion
AC , very efficacious
Each gm absorb 550g of
drug

Alkalinize with sodium

bicarbonate
1-2mEq/kg I.V push
150mEq/kg in1liter D5W
maintenace Haemodialysis
vey effective