This document provides information on antidotes and treatments for various drug poisonings and overdoses. It lists specific antidotes and dosages for acetaminophen, amphetamines, atropine, belladonna, benzodiazepines, carbon monoxide, cyanide, ethylene glycol, heavy metals including mercury, arsenic and lead, heparin, iron, isoniazid, methhemoglobinemia, and methyl alcohol poisonings. The document also provides guidance on administering antidotes like naloxone, atropine, pralidoxime, diphenhydramine, glucagon, and vitamin K.
This document provides information on antidotes and treatments for various drug poisonings and overdoses. It lists specific antidotes and dosages for acetaminophen, amphetamines, atropine, belladonna, benzodiazepines, carbon monoxide, cyanide, ethylene glycol, heavy metals including mercury, arsenic and lead, heparin, iron, isoniazid, methhemoglobinemia, and methyl alcohol poisonings. The document also provides guidance on administering antidotes like naloxone, atropine, pralidoxime, diphenhydramine, glucagon, and vitamin K.
This document provides information on antidotes and treatments for various drug poisonings and overdoses. It lists specific antidotes and dosages for acetaminophen, amphetamines, atropine, belladonna, benzodiazepines, carbon monoxide, cyanide, ethylene glycol, heavy metals including mercury, arsenic and lead, heparin, iron, isoniazid, methhemoglobinemia, and methyl alcohol poisonings. The document also provides guidance on administering antidotes like naloxone, atropine, pralidoxime, diphenhydramine, glucagon, and vitamin K.
N-acetyl cysteine 140 mg / kg followed by 70 mg / kg every 4 hours for 68 hours (17 doses) as oral solution. Chlorpromazine 1 mg / kg IM or IV. Pilocarpine 2-4 mg orally or 0.25-0.5 mg IM. Physostigmine 1-2 mg IM every 30 min. Physostigmine 0.5-2.0 mg IM every 30 min. Neostigmine is ineffective because it does not enter the CNS. Flumazenil IV in incremental doses of 0.1, 0.2, 0.3, 0.5 mg at 1-min intervals until desired effect is achieved. 100% oxygen inhalation or hyperbaric oxygen therapy. i. Amyl nitrite (vaporal) 0.3 ml inhalation for 15-30 sec after every min. ii Sodium nitrate 3% solution, 0.33ml / kg (max 10 ml) slowly IV. iii. Sodium thiosulphate 1.65 ml / kg 25% solution (max 50 ml) at a rate of 2.5-5.0 ml per min IV. Ethanol 10 ml/kg 10% solution IV or 1 ml/kg of 95% by month. Maintenance dose is 1.5 ml/kg/hr 10% solution IV or 3 ml/kg/hr 10% solution IV during hemodialysis. i. British anti-lewisite (BAL) 12-24 mg/kg/day in 6 divided doses IM (BAL or dimercaprol 100 mg/ml; 3 ml amp). ii. ETDA (calcium disodium ethylene diamine tetra acetic acid) 50-75 mg / kg / day in 4 div doses IM or IV as 0.2-0.4% solution (200 mg / ml ampoule). iii. d-Penicillamine 20-40 mg / kg per day orally for 5 days. iv. Oral thiamine and dimercapto succinic acid (DMSA) is useful. 2.0 mg protamine sulfate for 100 units heparin as 1% solution IV (10 mg / ml ampoule). Deferoxamine 15 mg / kg / hr IV infusion. Therapy needed for 12-36 hours till urine color becomes normal (desferal 500 mg / vial). Pyridoxine 1.0mg IV for every 1.0 mg of isoniazid upto a maximum of 500 mg if amount of isoniazid ingested is umknown. Methylene blue 1-2 mg/kg/hr IV 1% solution. May be repeated after 4 hours (10 mg/ml ampoule) Maximum dose is 7 mg/kg. Ethyl alcohol (ethanol) 0.75-1.0 ml/kg IV followed by 0.5 ml/kg every hourly IV as 5% solution in sodium bicarbonate. Alternatively it can be given as 3-4 ounces of whisky (45% alcohol) every 4 hourly for 1-3 days in adults (Ing ethanol 2 ml ampoule). 1. Acetaminophen (paracetamol) Toxic dose: 150 mg / kg 2. Amphetamines Toxic dose: 50 mg 3. Atropine 4. Belladonna (Dhatura) 5. Benzodiazepines 6. Carbon monoxide 7. CyanideFatal dose: 200-300 mg 8. Ethylene glycol 9. Heavy Metals i. Mercury i, ii,iii. Arsenic i,iii. Lead i, ii, iii, iv. 10. Heparin 11. Iron Toxic dose: 35 mg / kg 12. Isoniazid 13. Methemoglobinemia 14. Methyl alcohol Poison Antidote 14 Naloxone 0.1 mg / kg IV (max 2 mg) Repeat every 2-3 min till the reversal of toxic effects or a cumulative dose of 10 mg is reached (Ing narcan 0.4 mg / ml). i. Atropine 0.02-0.05 mg / kg / dose IV every 15-30 min till signs of atropinization develop. For continuous infusion 0.02-0.08 mg / kg / hour after the initial bolus. ii. PAM or pralidoxime (2-Pyridine aldozime methiodide) 25-50 mg / kg IM or IV as 5% solution over 15-30 minutes. The dose may be repeated after 1-2 hours and then at 10-12 hours intervals if cholinergic signs recur. For continuous infusion 9-19 mg/kg/hour after the initial bolus of 25-50 mg / kg. Diphenhydramine 1-2 mg / kg / IV every 30 min. (benadryl cap 25 mg; 50 mg ; elixir 12.5 mg / 5 ml; amp 50 mg/ml; vials 10 mg / ml). Atropine 0.01-0.02 mg / kg per dose SC every 5-10 min to achieve full atropinisation. Glucagon 0.25-1.0 mg IM or IV (Glucagon amp 1 mg / ml). Vitamin K 5-10 mg IM or IV (Inj kapilin 10 mg / ml)