How The Poison Enter Into The Body ?
The Poison In Any Form may be taken in by the breath Or swallowed, Absorbed Through the thinner and more delicate mucous membranes, Or absorbed through the skin, or implanted by stings, bites, or other wounds.
There Are A lot Of Antidotes In The Medical Field Today But Some Antidotes Are Very Important And Need To Be Remembered Because Of Their Frequent Use In The Emergency Situations. Knowledge About Antidotes Is Very Important For All Medical Professionals Especially Those Who Are Working In Health Care Settings.Here Are Some Of The Types And List Of Very Important And Frequently Used Antidotes ;
Types of Antidotes
1: Universal Antidotes :This type of antidote is Given when unknown poison is ingested
(1):powdered charcoal 2 parts
(2):Magnesium oxide 1 part
(3):Tannic Acid 1 Part
2: Chemical Antidotes :These substances neutrilize the chemical action or oxidize the poison into nontoxic or insolouble form
- Dilute alkali(milk of magnesia)
- Dilute acetic acid,
- Potassium permangante
- Tannin(strong tea).
3: Physiological or pharmacological Antidotes
These produce effects opposite to that of poison
- Naloxone for morphine,
- Atropine and oxime for organophosphorous poison,
- N-acetylcysteine for acetaminophen
4: Mechanical or physical Antidotes :
These substances prevents the absorption of poison by their presence
- Activated charcoal is used for strychinine.
- Emulcents(fats,oils,milk,eggalbumin) are used for corrosive and irritant poisoning,
- Bulky food used for glass poisoning And mineral poisoning(dose 30-60 gms for children and 60-100gms for adults)
5: Chelating agents:
These are substances which form chelates(non ionized complexes) with cations.These are mostly used in heavy metal poisoning
- N-pencillamine for mercury,lead,copper
- BAL(dimercepol) is used in heavy metal poisons
- EDTA is used in Arsenic,mercury,lead
- Versenate is used in Arsenic,mercury and lead
- Desferoxamine is used for iron.
Important Antidotes List :
- Non-specific poisons except cyanide, iron, lithium, caustics and alcohol = Activated charcoal
- Cobra bite = Snake Anti-Venin.
- Heparin = Protamine Sulfate
- Gas=Use artificial respiration,Remove patient to air, apply heat to extremities; send for doctor.
- Absinthe = Give an active emetic; then flaxseed tea freely; stimulate
- Insulin reaction = Glucose (Dextrose 50%)
- Alkali, Volatile = Drink freely of water with vinegar or lemon juice in it.
- Antimonial Wine = Give warm water freely to encourage vomiting.
- Aqua Fortis = Magnesia or soap dissolved in water, every two minutes.
- Bed Bug Poison = Give milk or white of eggs in large quantities.
- Belladona = Active emetic; stimulate.
- Acetaminophen/Paracetamol = N-Acetylcysteine or Mucomyst
- Anticholinergics, diphenhydramine, dimenhydrinate =Physostigmine
- BenzodiazepinesZaleplonZolpidem = Flumazenil (Romazicon)
- Calcium Channel Blockers = Calcium Chloride, Glucagon
- Cyanide = Amyl nitrite, sodium nitrite, sodium thiosulfate
- Iron = Deferoxamine
- For Chemicals causing methemoglobinemia in patients with G6PD deficiency = Vitamin C
- For Lead = EDTA, dimercaprol, succimer
- Methanol = Folic acid
- Ammonia = Lemon juice, diluted vinegar or acetic acid.
- Methotrexate = Leucovorin calcium
- Potassium = Insulin + Glucose, Kayexalate
- Mercury = White of eggs freely; afterwards evacuate; mild drinks
- Valproic acid = L-Carnitine
- Isoniazid, ethylene glycol = Pyridoxine HCl (Vitamin B6)
- Tricyclic antidepressants = phyostigmine or NaHCO3
- Sulfonylureas = Octreotide (Sandostatin )
- Alpha agonists (e.g., clonidine), Opioids (e.g., codeine, diphenoxylate, fentanyl, heroin, meperidine, morphine and propoxyphene = Naloxone
- Arsenic, Copper, Lead, Mercury = D-Penicillamine (Cuprimine )
- Neuromuscular blockade = anticholinesterase agents.
- Anticholinesterase = atropine sulfate or pralidoxime.
- Fluoride ingestion = Calcium salts
- Digoxin = digibind digoxine immune fab
- Beta blockers and calciumchannel blockers = glucagon
- Ergotamine = Heparin
- Dopamine = Phentolamine.
Patients with poisoning characteristics should normally be hospitalized. Patients who have taken delayed-action toxins should also be admitted, even if they appear to be well. The delayed-action poison includes aspirin, iron, tricyclic antidepressant, paracetamol and co-phenotropic. The effects of the modified release preparations are also delayed.
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