Types of Antidotes

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TYPES OF ANTIDOTES

o Chemical Antidote – changes the chemical nature of the poison; inactivation; Chemical antagonism
(Protamine sulphate for heparin toxicity)
o Mechanical Antidote – prevents absorption of the poison; Dispositional antagonism
Example: Activated Charcoal; Copper Sulfate; Magnesium Sulfate; Syrup of Ipecac
o Pharmacological Antidote – produces an opposite effect as that of the poison by binding to same receptors;
Receptor antagonism
Example: Atropine for organophosphates; antihistamines for allergy; Naloxone for opioids
o Physiological Antidote – produces an opposite effect as that of the poison by binding to different receptors;
Functional antagonism
Example: Epinephrine and histamine

INDICATION ANTIDOTE
Anaphylaxis and hypotension Epinephrine
Arsenic, mercury, lead and gold BAL or Dimercaprol
Atropine Physostigmine and Neostigmine
Barium Magnesium sulfate
Benzodiazepines Flumazenil
Beta-blockers Glucagon
Carbon monoxide, carbon tetrachloride, cyanide and Oxygen
hydrogen sulfide
Cardiac glycosides Digoxin specific antibodies
Copper, lead and mercury Penicillamine
Coumadin or warfarin Vitamin K1
Hydroxocobalamin
Cyanide Nitrite (amyl and sodium)
Thiosulfate sodium
Dystonia from neuroleptics Benztropine
Ethanol and ethylene glycol Thiamine
Heparin Protamine
Hypertensive crisis, drugs of abuse, MAOI and clonidine Phentolamine
Iron Deferoxamine
Isoniazid and ethylene glycol Pyridoxine
Lead, zinc, manganese, iron, copper EDTA
Malignant hyperthermia Dantrolene
Management of oral poisoning Apomorphine
Metabolic acidosis from methanol, ethylene glycol or Bicarbonate sodium
salicylates
Methanol Leucovorin calcium
Ethanol
Methanol and ethylene glycol Folic acid
Fomepizole
Methemoglobinemia Methylene blue
Opioids and opiates Naloxone
Oral medications or poisons Charcoal
Oral poisonings Ipecac syrup
Organophosphate and carbamates Atropine
Pralidoxime
Paracetamol, carbon tetrachloride Acetylcysteine
Sympathomimetic drugs, hallucinogens, strychnine and Benzodiazepines
chloroquine
Thallium and cesium Prussian Blue

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