Antidotes

Related FACEM curriculum (2022) learning objectives:

• ME 3.8.1.6(e) Principles of management of toxicological presentations including: Indications for antidotes
• ME 3.8.2.4 Identify the appropriate antidote or antivenom.

• Correct the effects of poisoning
• Rarely used (apart from N-acetylcysteine)
• Administered based on risk-benefit analysis (patient, resource, cost based considerations)
• Stocking and storage regimes differ depending on jurisdiction
  • e.g., VicTAG - Emergency and Life Saving Medicines Register
• Often safer and cheaper to transport antidote to patient rather other way around

Specific antidotes

Atropine (antidote) - AV conduction block and organophosphate
Activated charcoal - general adsorbent
Calcium (antidote) - CCB, hydrofluoric acid, hyperkalaemia, hypermagnesaemia
Cyproheptadine - mild/moderate serotonin toxicity
Desferrioxamine - iron
Dicobalt edetate - cyanide
Digoxin immune Fab - digoxin and other cardiac glycosides
Dimercaprol
Ethanol (antidote)
Flumazenil
Folinic acid (antidote)
Fomepizole
Glucose (antidote)
Hydroxocobalamin (antidote)
High insulin euglycaemia therapy
Intravenous lipid emulsion
Methylene blue
N-acetylcysteine
Naloxone
Octreotide
Penicillamine
Physostigmine
Pralidoxime
Pyridoxine
Sodium bicarbonate (antidote)
Sodium calcium edetate
Sodium thiosulfate
Succimer
Vitamin K (antidote)