Commonly used pharmaceutical Antidotes

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!
Cyanide	Cyanide Antidote:
	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!
Organophosphates compounds
	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!