Toxicology 2

Atropine

Carbamates

Primarily for treatment of muscarinic effects.

Atropine
Pralidoxime/2-Pam

Organophosphates

For treatment of muscarinic effects.
For treatment of nicotinic effects.

Black Widow Antivenin

Black Widow Spider

Reserved for severe cases.
Not always readily available.

Botulinum Antitoxin

Botulism

Given for confirmed cases. Several types available. Must obtain from CDC.

Calcium EDTA

BAL (dimercaprol)

DMSA (Succimer)

Lead/Other Heavy Metals

Based on levels and symptomatology.

Can not be given to patient with peanut allergy.

Must monitor LFT’s with this therapy.

Calcium

Hydrofluoric Acid

Case specific, dermal/IV for systemic toxicity.

Coral Snake Antivenin

Coral Snake

Different types, match antivenin to correct coral snake.

Crotalidae Polyvalent Antivenin

Pit Viper Snake

Requires skin test.

Antivenin not always indicated.

Cro-Fab

Pit Viper Snake

No skin test required.
Antivenin not always indicated.

Cyanide Antidote Kit

CyanoKit

Cyanide

Three components to kit amyl/sodium nitrite and sodium thiosulfate). For symptomatic patients.

Hydroxocobalamin

Deferoxamine

Iron

Based on levels and symptomatology.

Digibind/Digoxin Fab Fragments

Digoxin

Used for severe toxicity.

Ethanol

Fomepizole

Pyridoxine

Thiamine

Ethylene Glycol

Oral or IV.

May shorten hospital stay.

An adjunct to other therapies.

An adjunct to other therapies.

Ethanol

Fomepizole

Folinic Acid, Folic Acid

Methanol

Oral or IV.

May shorten hospital stay.

Given IV.

Flumazenil

Benzodiazepines

Use with caution, many contraindications.

Glucagon

Beta Blockers

Used with significant symptoms.

Methylene Blue

Methemoglobinemia

Based on methemoglobin levels.
Several toxins can induce this condition.

NAC/Mucomyst/N-Acetylcysteine

Acetaminophen

Given diluted orally.
IV route not FDA approved.

Naloxone

Nalmefene

Opiates, Clonidine

Short- acting.

Longer-acting.

Octreotide

Sulfonylureas

Inhibits growth hormone and insulin secretion.

Physostigmine

Anti-cholinergics

Used only in rare and severe poisonings.

Protamine Sulfate

Heparin

In severe overdose and marked lab indications.

Pyridoxine

Isoniazid

Dose often dependent on amount INH ingested.

Scorpion Antivenin

Scorpion

No FDA approved antivenin available. An intrastate one used in Arizona. Many types, not all poisonous.

Vitamin K 1

Anticoagulants/Rat Poisons/Warfarin

Given to any patient with prolonged PT.