Table of Antidotes

Table of Antidotes Antidote Indication Mode of Action acetylcysteine (Mucomyst) Acetaminophen/ Tylenol/ Paracetamol Restores depleted glutathione stores and protects against renal and hepatic failure. Activated charcoal Non-specific poisons except cyanide, iron, lithium, caustics and alcohol. Absorption of drug in the gastric and intestinal tracts. Interrupts the entero-hepatic cycle with multiple dose. albuterol inhaler, insulin & glucose, NaHCO3 , kayexalate Potassium anticholinesterase agents Neuromuscular blockade (paralytics) atropine sulfate or pralidoxime Anticholinesterase Competitive inhibition of muscarinic receptors. Benzylpenicillin Amanita phalloides (Death cap mushroom) Not known; partial protection against acute hepatic failure; may displace amatoxin from protein-binding sites allowing increased renal excretion; may also inhibit penetration of amatoxin to hepatocytes. Calcium salts Fluoride ingestion Rapidly complexes with fluoride ion. deferoxamine Iron Deferoxamine acts by binding free iron in the bloodstream and enhancing its elimination in the urine. digibind digoxine immune fab Digoxin Binds molecules of digoxin, making them unavailable for binding at their site of action on cells in the body. dimercapol, edetate calcium, disodium, Lead Chelation of lead ions and endogenous metals (e.g., zinc, manganese, iron, copper). diphenhydramine (Benadryl) Extrapyramidal symptoms (EPS) A potent antagonist to acetylcholine in muscarinic receptors. flumazenil Benzodiazepines Reverses the effects of benzodiazepines by competitive inhibition at the benzodiazepine binding site on the GABAAreceptor. fomepizole Ethylene glycol A competitive inhibitor of the enzyme alcohol dehydrogenase found in the liver. This enzyme plays a key role in the metabolism of ethylene glycol and methanol. glucagon Beta blockers and calcium channel blockers Stimulates the formation of adenyl cyclase causing intracellular increase in cycling AMP and enhanced glycogenolysis and elevated serum glucose concentration. Glucose (Dextrose 50%) Insulin reaction Dextrose (the monosaccharide glucose) is used, distributed and stored by body tissues and is metabolized to carbon dioxide and water with the release of energy. Heparin Ergotamine Reverses hypercoagulable state by interacting with antithrombin III. Used in combination with vasodilator phentolamine or nitroprusside to prevent local thrombosis and ischemia. Hydroxocobalamin Cyanide Forms cyanocobalamin, a non-toxic metabolite that is easily excreted through the kidneys. leucovorin calcium Fluorouracil Methotrexate Protects the healthy cells from the effects of methotrexate