Antidotes for Poisoned Patients

ANTIDOTES
(Generic Name & Trade Names)
Acetylcysteine (Mucomyst, Acetadote) Antivenom (Latrodectus mactans) Atropine Benztropine (Cogentin) Botulinum antitoxin / trivalent ABE Calcium disodium EDTA (Versenate) Calcium gluconate 10% Crotalinae polyvalent immune FAB (CroFab) Cyproheptadine (Periactin) Dantrolene (Dantrium) Deferoxamine mesylate (Desferal) Diazepam / lorazepam (Valium / Ativan) Digoxin-specific antibody fragments (Digifab, Digibind) Dimercaprol / BAL Diphenhydramine (Benadryl) Flumazenil (Romazicon) Folic acid (Folvite) Fomepizole (Antizol) Glucagon Hydroxocobalamin (Cyanokit) Leucovorin calcium Levocarnitine (Carnitor) Levoleucovorin calcium Methylene blue 1% Naloxone (Narcan) Octreotide (Sandostatin) Physostigmine (Antilirium) Phytonadione / Vitamin K1 (AquaMEPHYTON / Mephyton) Pralidoxime / 2-PAM (Protopam) Protamine Pyridoxine / Vitamin B6 Sodium bicarbonate Succimer / DMSA (Chemet) Thiamine / Vitamin B1

POISONING OR OVERDOSE INDICATIONS

Acetaminophen toxicity Black widow spider envenomation Bradydysrhythmias, cholinesterase inhibitor toxicity Acute dystonia Botulism Lead, copper, zinc, cobalt, cadmium toxicity Hydrofluoric acid exposure, calcium channel blocker toxicity Crotalinae (rattlesnake) envenomation Serotonin syndrome Malignant hyperthermia, neuroleptic malignant syndrome Iron toxicity Seizures, severe agitation; stimulant toxicity Digoxin and other cardiac glycoside toxicity Arsenic, lead, mercury toxicity Acute dystonia; histamine receptor blockade Benzodiazepine toxicity Methanol toxicity Ethylene glycol, methanol toxicity Beta-blocker, calcium channel blocker toxicity Cyanide exposure / smoke inhalation Methotrexate toxicity Valproic acid toxicity Methotrexate toxicity Methemoglobinemia Opioid toxicity Sulfonylurea toxicity Anticholinergic toxicity Oral anticoagulant / rodenticide toxicicty Cholinesterase inhibitor (organophosphate / carbamate) toxicity Heparin reversal Ethylene glycol / isoniazid / Gyromitra mushroom toxicity Cyclic antidepressant / salicylate toxicity, metabolic acidosis Arsenic, lead, mercury Wernicke-Korsakoff syndrome, ethylene glycol toxicity

RECOMMENDED STOCKING LEVEL*

20% oral solution-7 x 30mL; 20% IV solution-4 x 30mL 1 vial 1g 3 x 2mL, 1mg/mL Available from CDC 18 x 5mL, 200mg/mL 20 -30 vials, 1 gram each 10-20 vials 32mg (4mg tablets or 2mg/5mL syrup) 35 x 20mg vials 12x 500mg vials 20mg parenteral formulation 15-20 vials 6 x 3mL, 100mg/mL 8 x 1mL, 50mg/mL 10 x 10mL, 0.1mg/mL 6 x 10mL, 5mg/mL 4 x 1.5mL, 1g/mL 100mg (100 kits, 1unit each) 15g (3 kits) 2 x 10mL, 10mg/mL 7 x 5mL, 1g/5mL 1 x 50mg vial 5x 10mL, 10mg/mL 3 x 10mL, 1mg/mL 2 x 1mL, 0.1mg/mL 10 x 2mL, 1mg/mL 10 x 1mL, 10mg/mL; 20 x 5mg tablets 12 x 1g vials 1 x 25mL, 10mg/mL 7 x 30mL, 100mg/mL 10 amps or syringes (~500mEq) 21 x 100mg capsules 5 x 2mL, 100mg/mL

*Recommended stocking amounts should provide a 24-hour supply to treat a severely poisoned 70-kg patient. Institutional needs may vary. The Utah Poison Control Center is available 24 hours a day for toxicology consultation and is a program of the University of Utah College of Pharmacy.