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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 |
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) |