ANTIDOTES

POISON
Any substance that can cause severe organ
damage or death if ingested, breathed in, injected
into the body or absorbed through the skin.
 ANTIDOTES
 Antidotes is an chemical agent that counteracts a
particular poison.

Mechanism of ANTIDOTES
It mainly act by three ways

1. Chemical Antidote

2. Mechanical Antidote

3. Physiological Antidote
 MECHANISM OF ANTIDOTES

1. Chemical Antidote :
 The antidote that changes the chemical nature of
poison.

e.g. Sodium thiosulphate.

 Sodium thiosulphate is chemical antidote , which
converts the systematically toxic cyanide to nontoxic
thiocyanate. Rhodanese

Na2S2O3 + CN- ------------> SCN- + Na2SO3

MECHANISM OF ANTIDOTES
2. Mechanical Antidotes :
 The antidote that prevent absorption of poison into the
body.

e.g. Activated charcoal

 Activated charcoal is mechanical antidote, which adsorb

the poison, prior to its absorption across the intestinal
wall.

.
 MECHANISM OF ANTIDOTES
3 Physiological antidotes:
 The antidote that counteracts the effects of poison by producing other effects.

e.g. Sodium Nitrite

 Sodium Nitrite is physiological antidote , Which converts haemoglobin into

methaemoglobin in order to bind to cyanide.
 The cyanide ions combine with the methaemoglobin to produce
cyanmethaemoglobin, thus protecting cytochrome oxidase from the cyanide
ions.
 The cyanmethaemoglobin dissociates, setting free cyanide, which is
converted to non-toxic thiocyanate by sodium thiosulphate.
 CYANIDE POISONING
Cyanide (CN-) readily combines with ferric ion cytochrome oxidase enzyme
present in the cell. It stops electron transfer and thus the cellular oxidation-
reduction reactions leading to cell death.
Cyanide poisoning is treated with a combination of sodium nitrite and
sodium thiosulfate.

Sodium Nitrite
Causes oxidation of ferrous ion of hemoglobin to the ferric ion of
methemoglobin which then combines with serum cyanide that has not yet
entered the cell.
Following sodium nitrite injection, a slow intravenous infusion of sodium
thiosulfate is given
Sodium thiosulphate
The thiosulfate anion catalyzed by the enzyme rhodanase reacts with cyanide
to form relatively non toxic thiocyanate ion which is excreted in the urine.

Hyperbaric oxygen administration- (Hyperbaric oxygen therapy :100%

oxygen given at 1.5 to 3 atm absolute pressure)
A large excess of oxygen may displace cyanide from cytochrome oxidase.
SODIUM NITRITE

CHEMICAL FORMULA: NaNO2 (Mol. Wt.: 69)

PHYSICAL PROPERTIES:

1. It occurs as colorless/white to slightly yellow crystals

2. It has a mild saline taste, odourless & deliquescent in air.

3. Its aqueous solution is alkaline to litmus.

4. It is soluble in water & sparingly soluble in alcohol.

 Chemical Properties:
 Sodium nitrite react with sulfuric acid to produce
sodium sulfate, nitric oxide, nitrogen dioxide and
water.
2NaNO2 + H2SO4 → Na2SO4 + NO + NO2 + H2O

 Sodium Nitrite also act as an Oxidising Agent.

2HNO2 + 2KI + H2SO4 I2 + 2NO + 2H2O + K2SO4

 Storage: Store in well closed air-tight container.

 Incompatibility: with oxidising agent,
acetanilide, caffeine citrate & morphine.
 USES
 It is used as an official antidote of cyanide poisoning. It
is given IV, in conjunction with Sod. Thiosulphate.
 It is added to disinfectant sol to prevent rusting of
surgical instruments.
 It is used as an antioxidant.
 It is widely used in meat packing as preservative. It
restrict growth of clostridium botulinum bacterial spores.

DOSAGE:
 Intravenous 10 to 15 ml of 3 % solution.
SODIUM THIOSULPHATE
CHEMICAL FORMULA: Na2S2O3 · 5H2O

PHYSICAL PROPERTIES:

1. It occurs as colorless/ white to slightly yellow crystals

2. It is also present as granular powder

3. It has a mild saline taste, odourless & deliquescent in air.

4. Its aqueous solution is alkaline to litmus.

5. It is soluble in water

6. Practically insoluble in alcohol.

7. Store in air tight container

8. Protect from light and moisture

Preparation :
 Prepared by heating sodium sulphite with powdered sulphur in iron
vessel
Na2SO3 + S ------> Na2S2O3
 Prepared by reacting sodium hydroxide with powdered sulphur
6NaOH + 4S ------> Na2S2O3 + 2Na2S + 3H2O

 Storage: Store in well closed air-tight container.

 Incompatibility: with oxidising agent

 Use:
1. It is used as antidote in cyanide poisoning
2. It is used in dermatological problems
3. It is used as anti-oxidant in iodide containing solutions
4. It acts as fixer in photography
5. It is used as antichlor in bleaching process in textile
ACTIVATED CHARCOAL
Preparation
1. It is obtained by condensation of organic matter from
vegetable sources

2. This charcoal need activation to increase adsorptive power,

porosity, and surface area.

3. Activation is done by exposing the material to steam, air,

carbon dioxide, sulphuric acid, or phosphoric acid at high
temperature.

4. It causes the charcoal to develop lots of internal spaces or

“pores.” These pores help activated charcoal “trap”
chemicals.

5. This material is called as activated charcoal

 ACTIVATED CHARCOAL
1. It adsorb alkaloids and other amines, gases such as ammonia, nitrous
oxide, carbon monoxide, carbon dioxide, oxygen, nitrogen and
hydrogen and certain salts of heavy metals.

2. Drugs that effectively bound to charcoal include acetaminophen,

aspirin, barbital, chloroquine. I poorly adsorb potassium cyanide.

3. The charcoal-poison complex remains stable throughout

gastrointestinal tract.

4. Activated charcoal in ratio of 5:1 to 10:1 is usually administered

5. It must be administered as soon as possible following ingestion of the

poison.
 ACTIVATED CHARCOAL
Description
1. It is practically insoluble in water and other common organic solvents

2. On heating to redness, it burns slowly without flame

Use

3. It is used as adsorbent in poisoning and flatulence.

4. Poisons like alkaloids and some synthetic drugs are adsorbed when it is
administered orally

5. In flatulence gas is adsorbed. For this purpose it is mixed with kaolin

6. Externally it can be used as a deodorant for foul smelling wounds and ulcers
 HAEMATINIC
 Anaemia is a condition in which the number of red blood cells (RBC)
or their oxygen-carrying capacity is insufficient to meet physiologic
needs

 A hematinic is a nutrient required for the formation of red blood cells.

Deficiency in hematinic can lead to anaemia.

The main hematinics are

1. Iron,
2. Vitamin B12
3. Folic acid

 Erythroblasts require folate and vitamin B12 for proliferation during

their differentiation.
 Deficiency of folate or vitamin B12 inhibits purine and thymidylate
syntheses, impairs DNA synthesis, and causes erythroblast apoptosis,
resulting in anemia from ineffective erythropoiesis.

 Erythroblasts require large amounts of iron for hemoglobin synthesis.

 RBC - HAEMOGLOBIN
R
 IRON
Role
1. Iron plays important role in respiration.
2. It is responsible for transport of molecular oxygen.
3. It functions as electron carrier in metabolic process in the cell. .
4. It is required in synthesis of hemoglobin.
5. It is required in synthesis of metabolic enzymes such as cytochromes

Distribution of iron in body

 66% - present as heme in Haemoglobin and helps
in transport of oxygen
 25 % - is stored in the cellular protein called
ferritin, and blood protein called
transferrin
 3%- is stored in myoglobin
 6%- is present as a part of enzymes such as
cytochromes
 IRON STORAGE
1. Ferritin, hemosiderin and transferrin are iron storage proteins.

2. Ferritin is water soluble. It store iron in the Fe +3 form.

3. Hemosiderin is water insoluble and is considered as dehydrated ferritin.

4. Transferrin - The major iron transport protein of blood plasma is

glycoprotein known as transferrin. It binds two atoms of ferric iron per
molecule very tightly. Due to this reason there is no free plasma iron.
 ANEMIA
Anemia is a condition in which circulating RBCs are deficient in number,
or deficient in total hemoglobin content.

Causes of anemia
1. Excessive blood loss or destruction. (due to hemorrhage, menstrual
flow, bleeding ulcer)
2. Decreased RBC formation due to deficiencies in folic acid, iron.
3. Less intake of vitamins and protein.
4. Diminished absorption of iron.

Treatment for anemia :-

• Hematinic – These are agents that stimulate the production of RBCs
or increases the amount of hemoglobin in blood.
• Hematinic agents- Iron, folic acid, vitamin B12.

20
 IRON IN ANEMIA
• Iron can be given orally or parenterally
• Oral iron corrects the deficiency as rapidly and completely as
parenteral iron.
• For iron supplements oral route is preferred.
• Ferrous salts are better absorbed.

1. Ferrous sulphate,
2. Ferrous gluconate

21
 FERROUS SULPHATE
Physical properties
1. Molecular weight – 278.02
2. Molecular formula – FeSO4.7H2O
3. It occurs as pale, bluish green crystals or granules
4. They are odourless
5. It has saline taste
6. Solution is acidic
7. It is feely soluble in water
8. It is insoluble in alcohol

Preparation
1. Ferrous sulphate can be prepared by adding iron filing to the dilute
sulphuric acid. When the effervescence of hydrogen ceases the
solution is concentrated and cooled to get the crystals
Fe + H2SO4 ------> FeSO4 + H2

2. It can also be prepared by displacement reaction, where iron

displaces copper from Copper sulphate solution to form ferrous
sulphate. The solution is concentrated and cooled to get the crystals
Fe + CuSO4 ------> FeSO4 + Cu
 FERROUS SULPHATE
Chemical properties
1. On heating it decompose into ferric oxide, sulphur dioxide and
sulphuric acid
2FeSO4.7H2O -------> Fe2O3 + SO2 + H2SO4 + 13H2O

2. Ferrous reduces silver and gold salts to corresponding metal

Ag+ + Fe2+ ---------> Ag + Fe3+
Au3+ + 3Fe2+ ---------> Au + 3Fe3+
 FERROUS SULPHATE
Use
1. It is widely used in iron preparations
2. It is drug of choice in iron deficiency anemia
3. It can be irritating to GI mucosa due to astringent effect of
soluble iron
4. They are available as
a. Ferrous sulphate tablets – available as 300 mg
b. Ferrous sulphate syrup – 40 g in 1000 ml
c. Iron dextran injection – it is colloidal l solution of ferric
hydroxide complex with dextran – 100 mg iron daily
d. Iron sorbitex Injection – solution of iron, sorbitol and
critic acid.
 FERROUS GLUCONATE
Physical properties
1. Molecular weight – 482.2
2. Molecular formula – C12H22O14Fe.2H2O
3. It is yellowish grey or pale greenish yellow fine powder
4. It has odour resembling brunt sugar. It is soluble in water. It is
insoluble in alcohol
5. Aqueous solution is acidic in nature

Preparation
1. It is prepared by reaction between calcium gluconate and ferrous
sulphate. Ferrous ions displace calcium, leading to formation of
ferrous gluconate.
C12H22O14Ca + FeSO4 --------> C12H22O14Fe + CaSO4

Chemical properties
1. It gives reactions which are characteristics of ferrous sulphate.
2. Ferrous ions gets oxidised to ferric ions by oxygen. Hence it is
to be stored in closed container.
2+ 3+
 FERROUS GLUCONATE
Dose:
300 mg three times a day

Use:
1. It is an iron supplement and used to treat or prevent low
blood levels of iron in anaemia or in pregnancy

2. Iron is best absorbed on an empty stomach (usually if taken 1

hour before or 2 hours after meals)

3. Common side effects may include:

1. constipation, diarrhoea;
2. nausea, vomiting, heartburn;
3. stomach pain, upset stomach;
4. black or dark-colored stools or urine; or
5. temporary staining of the teeth.
 ASTRINGENTS
 Astringent, any of a group of substances that cause “tightening” of cells or
tissues.

 These agents produced these effects mostly due to precipitation of proteins.

 Astringents are usually classified into three groups according to their mode
of action:
1. those that decrease the blood supply by capillaries or small blood
vessels (e.g., epinephrine and cocaine)

2. those that harden superficial tissue layers (e.g. salts of aluminum,

potassium, zinc, manganese, iron, bismuth).

3. those that abstract water from the tissue (e.g., glycerol and alcohol)

 With increase in concentration following activities can be observed.

Antimicrobial < Astringent < Irritant < Corrosive
MECHANISM OF ACTION
 ASTRINGENTS
 Use:

1. Styptic - stop bleeding from minor cuts by constricting small

capillaries.
2. Anti-perspirants – decrease secretion of perspiration by constricting
pores at the surface of the skin. In deodorants.
3. Antimicrobial -
4. Haemostatics – Promote blood clotting by precipitating blood proteins.
5. Gums ulcers –
6. Pyorrhea – inflammation and infection of ligaments and bones
supporting teeth
7. Reduce mucous secretions of nasal, gastrointestinal, and urinary
passages by decreasing blood supply to them
8. In higher concentration they remove unwanted tissues of the skin e.g.
wart.
CLASSIFICATION
 Vegetable astringents : Tannic acid, catechu

 Minerals – salts of aluminium, bismuth, barium,

copper, zinc and alums Eg. Zinc chloride, zinc
sulphate, ferric chloride, lead acetate
 ZINC SULPHATE
Physical properties
1. Molecular weight – 487.54
2. Molecular formula – ZnSO4·7H2O
3. It is colourless, transparent crystals
4. Odourless. Taste is astringent and metallic
5. It is soluble in water. It is insoluble in alcohol
6. Aqueous solution is acidic in nature

Preparation
1. It is prepared by boiling slight excess of metallic zinc with sulphuric
acid. When the effervescence of hydrogen ceases the solution is
concentrated and cooled to get the crystals
Zn + H2SO4 --------> ZnSO4 + H2
Chemical property
On strong heating, it loses water of crystallization leaving a residue of
zinc oxide 100°C 450°C
ZnSO4·7H2O ----------> ZnSO4·H2O------------> ZnSO4

740°C
 ZINC SULPHATE
Use :
As astringent paste, mouthwash was in oral care
Thank You…!!!