Antidote

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Definition
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Substance capable of eliminating or at least reducing the toxicity of toxins. Only for a few poisons there are specific antidotes (see Table 1), therefore the treatment of poisoning must be largely symptomatic.

Tables
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Overview of the most common antidotes and their indications

Antidote

Indication

Activated carbon (Carbo medicinalis)

Non-specific binding of fat- and water-soluble toxins (suspension of 30-50 g in approx. 300 ml p.o., children half)

Antidotum universale (2 parts activated carbon, 1 part tannic acid, 1 part magnesia usta)

Sublimate poisoning

Apomorphine hydrochloride

induces vomiting (as a mixed injection with Novadral), heroin, opiate addiction

Aquocobalamin acetate (Vit. 12a)

Immediate treatment of prussic acid poisoning

Atropine sulphate

Acetylcholinesterase inhibitors (alkyl phosphate, carbamate poisoning)

Bentonite

Herbicides of the bipyridylium group (50 g suspended in 500 ml NaCl 0.9% p.o.)

Berlin blue (iron(III) hexacyanoferrate(II)

Thallium poisoning (3 g p.o., exchanges cations for Tl on the surface)

bolus alba

Adsorbent for basic substances (alkaloids)

Calcium edetate sodium

lead, chromium, cobalt, vanadium, zinc, cadmium, radioactive metals

Calcium salts (gluconate, lactate)

Fluorides, oxalates, allergies (primrose, thymol, Hg compounds), also p.o.

Calcium trisodium DTPA

Lead

Desferrioxamine mesylate

Iron

Digitalis Antitoxin (Fab antibody)

Digitalisintoxication

Dimaval (DMPS)

Chronic poisoning with organ. and inorgan. mercury compounds, lead compounds, arsenic, copper

4-DMAP (4-dimethylamino-phenol)

Prussic acid, cyanides

DTPA calcium trisodium salt

Lead

Defoamers (Sab simplex, Lefax)

After taking foaming agents (detergent, washing-up liquid, etc.) 5 teaspoons Sab simplex, children 1 teaspoon

Acetic acid

Alkali burns (internal, diluted), lung irritation by ammonia (inhalation)

ethanol (95%)

Methanol (adjust blood level to 1 per mil), ethylene glycol, low molecular glycols

Flumazenil (Anexate)

Benzodiazepines

Folic acid (Folsan)

Methanol

Folinic acid (Leucovorin)

MTX intoxication, critical drop in leukocytes under MTX therapy

Fomepizole

ethylene glycol poisoning; methanol poisoning

Glucose 40%

Insulin, sulfonylurea

Hexamethylenetetramine

Phosgene

Ipecacuana Syrup (Crushing Syrup NRF)

To induce vomiting: From 5th year 30 ml Orpec p.o., up to 1.5 years 10 ml, up to 5 years 15 ml

Junik metered dose inhaler 100 μg

Toxic pulmonary oedema

Potassium hexacyanoferrate(II)

Copper salts: 0.6 g in water, 0.1% for gastric irrigation

Potassium iodide

Thallium: 1% p.o., formation of TII, TIII3

Potassium permanganate

Alkaloids: 0.1% p.o.

Kelocyanor (Co2-EDTA)

Prussic acid

Magnesia usta (MgO)

Acid binders (50 g/500 ml water p.o.)

macrogol 4000

see below for polyethylene glycol 400

Metalcaptase (D-Penicillamine)

Heavy metal poisoning (copper, lead, mercury, zinc, gold, cobalt)

Methionine

Paracetamol

Naloxone (Naloxone, Naloselect)

respiratory depression in cases of opiate, analgesic, ethanol or benzodiazepine poisoning

N-Acetylcysteine (Fluimucil Antidote)

Paracetamol

Sodium hydrogen carbonate

Metaldehyde, methanol, poisoning by tricyclic antidepressants: 200 ml 5% solution p.o. or i.v. in case of metabolic acidosis

Sodium iodide

Thallium: gastric lavage with 1% solution

Sodium sulphate (Glauber's salt)

Laxative: 1 tbsp in 1 glass of water, children 1 tsp in 1 glass of water

Sodium thiosulfate

Prussic acid: CN- is converted into SCN- in the body

Obidoxime (Toxogonin)

Phosphoric acid ester

Paraffin. Subliquid.

Fat-soluble toxins: Withdraws them by dissolving them in the gastrointestinal tract, 200 ml p.o., children 50-100 ml p.o.

Polyethylene glycol/Macrogol 4000 (Laxofalk)

External poisoning by phenol, cresol, nitrobenzene, aniline, possibly by hydrofluoric acid burns: Wash off the corresponding skin areas

physostigmine salicylate (anticholium)

Anticholinergic syndrome. Poisoning with belladonna alkaloids, spasmolytics, anti-Parkinson's drugs, antihistamines, etc.

Quantalan (colestyramine)

digitalisintoxication, vit. K1-antagonists

Toluidine blue

Methaemoglobin formers

Trometamol (Tris buffer, e.g. THAM)

Severe metabolic acidosis, alkalization in barbiturate and salicylate poisoning

vitamin K1

Vit. K1 antagonists (coumarin and derivatives)

Incoming links (3)

Acrodyny; Fomepizole; Paracetamol;

Outgoing links (1)

Poisoning;

Authors

Last updated on: 29.10.2020