This reminds me about that episode of Sherlock show when he was confused about two tablets, one is poison and the other is not! Actually, every single drug or tablet has both effects, the poisonous effect at the wrong dose and the remedy effect at the correct dose!
So, I am going to list the commonly used antidotes in pharmaceutical industry , trying to keep the list updated as possible, let me know if I missed one or you want to add an antidote, contact me!
N.B : The data included below in the table is for educational purposes! the full and complete urgent medical advices should be obtained from your local poison control center, Click here!
|Toxicity Of||Antidote||Adult Dose||Pedia Dose|
|Acetaminophen / Paracetamol||N-Acetyl Cysteine||140 mg/kg as loading dose followed by 70 mg/kg every 4 hours for 17 doses orally||Similar to the Adult dose!|
|Arsenic||Dimercaprol||10 mg/kg orally three times a day||Similar to the Adult dose!|
|B-Blockers||Glucagon||5-10 mg as IV bolus dose followed by 5 – 10 mg/hr IV infusion titrated to effect||0.15 mg as IV bolus dose followed by 0.1 mg/hr IV infusion titrated to effect|
|Carbamates||Atropine||2-4 mg IV as bolus ; repeat doses titrated to effect||1 mg/kg IV as bolus ; repeat doses titrated to effect|
|Digoxin||Digoxin immune antibody fragment||See leaflet instructions!||See leaflet instructions!|
|Opiods||Naloxone||0.2 – 4 mg IV titrated to effect||Similar to adult dose!|
|Salicylate ex: Aspirin||Sodium Bicarbonates||use of intermittent boluses of 1-2 mEq/kg titrated to clinical effect||Check insert leaflet!|
|Warfarin||1. Fresh Frozen Plasma||FFP for life threatening hemorrhage||Same as adult!|
|2. Vitamin K1||10 – 50 mg slow IV infusion; SC or orally.||0.6 mg/kg slow IV infusion SC or orally.|
|Isoniazid (INH)||Pyridoxine Vit. B6||1 g per gram INH ingested or 75 mg/kg IV if unknown and not exceed 5 g||1 g per gram INH ingested or 75 mg/kg IV if unknown and not exceed 5 g|
|Iron||Deferoxamine||5-15 mg/kg/hr IV infusion titrated to effect||Similar to Adult dose!|
|1. Sodium nitrate 3%||300 mg slow IV infusion||0.15-0.33 mL/kg to maximum 300mg slow IV infusion|
|2. Sodium Thiosulfate||12.5 g IV infusion||400 mg/kg up to 12.5 g IV infusion|
|ca channel blockers|
|Calcium chloride 10%||10 – 20 mL IV bolus; repeat doses and IV infusions common||0.1 – 0.2 mL/kg IV bolus; repeat doses and IV infusions common|
|Glucagon||5-10 mg as IV bolus dose followed by 5 – 10 mg/hr IV||0.15 mg as IV bolus dose followed by 0.1 mg/hr IV infusion titrated to effect|
|Benzodiazepines||Flumazenil||0.2 mg IV bolus titrated to effect or total dose of 3 mg||0.01 mg/kg IV bolus titrated to effect or total dose of 1-3 mg|
|Methemoglobinemia||Methylene Blue||1-2 mg/kg slow IV infusion; repeat doses are common||Similar to adult dose!|
|Anticholinergic compounds||Physostigmine Salicylate||1-2 mg slow IV infusion over 3-5 min titrated to effect||0.02 mg/kg slow IV infusion over 3-5 min. titrated to effect|
|Ethylene Glycol / Methanol|
|Ethanol 10%||Loading dose: 10 mL/Kg IV or Orally; Maintenance dose: 1-2 mL/kg/hr IV infusion or orally.||Similar to adult regimen!|
|Fomepizole||15 mg/kg IV bolus; repeated smaller doses may be necessary||Similar to adult regimen!|
|Atropine||2-4 mg IV as bolus ; repeat doses titrated to effect||0.1 mg/kg IV as bolus ; repeat doses titrated to effect|
|Pralidoxime HCL||1-2 g slow IV infusion followed by 500 mg/hr continuous infusion or 1 g every 4 hrs||20-40 mg/kg slow IV infusion followed 5-10 mg/kg/h continuous infusion or 20 mg/kg every 4 hrs.|
Thats it! I will keep it updated!
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