ANTIDOTE OR SPECIFIC TREATMENT FOR INTOXICATION

Toxin Antidote/Treatment
Acetaminophen N-Acetylcysteine (Mucomyst)
Aluminum Deferoxamine
Anticholinergic agents Physotigmine
Arsenic Dimercaprol; 2,3-dimercaptosuccinic acid; D-
penicilamine
Barbiturates Charcoal hemoperfusion; alkaline diuresis
(long-acting only)
Beta-blockers Glucagon
Benzodiazepines Flumazenil
Calcium channel blockers Calcium
Carbamazepine Charcoal hemoperfusion
Carbon monoxide Oxygen (normobaric or hyperbaric)
Cyanide Amyl nitrite, sodium nitrite, sodium
thiosulfate
Digoxin Digibind (Fab fragments)
Ethylene glycol; methanol Ethanol; hemodialysis; 4-methylpyrazol
Iron Deferoxamine
Isoniazid Pyridoxine
Isopropanol Hemodialysis
Lead Calcium disodium edetate; dimercaprol; 2,3-
dimercaptosuccinic acid; D-penicilamine
Lithium Hemodialysis
Mercury Dimercaprol; 2,3-dimercaptosuccinic acid; D-
penicilamine
Nitrites, nitrates Methylene blue
Opioids Naloxone
Organophosphate or carbamate Atropine, pralidoxime (controversial for
insecticide carbamates)
Salicylates Bicarbonate; hemodialysis; alkaline diuresis
Theophylline Charcoal hemoperfusion
Tricyclic antidepressants Bicarbonate

GENERAL SUPPORTIVE MEASURES IN TREATMENT OF DRUG

OVERDOSE

Maintain airway, adequate ventilation and oxygenation; provide tracheal

intubation if required.
Maintain adequate cardiovascular function—intravenous crystalloid solutions and
vasopressors (e.g., dopamine, norepinephrine) if required.
If comatose, administer glucose, thiamine, naloxone and oxygen.
For seizures, administer diazepam, phenytoin.
Decontaminate gastrointestinal system—perform gastric lavage; induce vomiting
if appropriate (syrup of ipecac); administer activated charcoal; administer
cathartic (sodium sulfate, magnesium sulfate, or sorbitol).

SYMPTOMS OF THE IMPORTANT TOXIDROMES

Toxidrome Symptom
Anticholinergic Blurred vision Choreoathetosis
Coma Dry skin
Decreased bowel sounds Fever
Flushing Hallucinations
 Ileus Mydriasis
Myoclonus Psychosis
Seizures Tachycardia
Urinary retention
Cholinergic Bradycardia Bronchorrhea
Defecation Emesis
Gastrointestinal distress (diarrhea)
Lacrimation Salivation
Urination
Opiate Altered mental status Bradycardia
Decreased bowel sounds Hypotension
Miosis Shallow respirations
Slow respiratory rate Unresponsiveness
Sedative hypnotic Ataxia Blurred vision
Coma Confusion
Delirium Diplopia
Dysesthesias Hallucinations
Hypotension Nystagmus
Paresthesias Respiratory depression
Sedation Slurred speech

Sympathomimetic Diaphoresis
Excessive speech
Excessive motor activity
Hallucinations
Hypertension
Hyperthermia
Insomnia
Restlessness
Tachycardia
Tremor
Withdrawal (opiate, sedative Diarrhea
hypnotic, or ethanol) Hallucinations
Hypertension
Hyperthermia
Lacrimation
Muscle cramps
Mydriasis
Seizures
Sweating
Tachycardia
vomiting