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Antidote

An antidote counteracts a form of poisoning.

Antidotes for anticoagulants are sometimes referred to as reversal agents.

Antidotes are substances or treatments used to counteract the effects of certain poisons or toxins.

The antidotes for some particular toxins are manufactured by injecting the toxin into an animal in small doses and extracting the resulting antibodies from the host animals’ blood. 

This results in an antivenom that can be used to counteract venom produced by certain species of snakes, spiders, and other venomous animals. 

Some animal venoms, especially those produced by arthropods: spiders, scorpions, and bees, are only potentially lethal when they provoke allergic reactions and induce anaphylactic shock.

Therefore there is no antidote for these venoms; however anaphylactic shock can be treated with epinephrine.

Some toxins have no known antidote.

Ingested poisons are frequently treated by the oral administration of activated charcoal, which adsorbs the poison and flushes it from the digestive tract, thereby removing a large part of the toxin. 

Poisons which are injected into the body are usually treated by the use of a constriction band which limits the flow of lymph and/or blood to the area, thus slowing the circulation of the poison around the body.

Agent                                                     Indication

Activated charcoal with sorbitol Used for many oral toxins

Acetylcysteine: Used as an antidote for acetaminophen (paracetamol) overdose, preventing liver damage.

Theophylline or Caffeine         Adenosine receptor agonist poisoning. 

Antimuscarinic drugs (e.g. Atropine)-Organophosphate and carbamate insecticides, nerve agents, some poison mushrooms

Atropine: Used as an antidote for certain types of poisoning, particularly from certain insecticides or nerve gases.

Beta blocker Theophylline

Calcium chloride  Calcium channel blocker toxicity,black widow spider bites

Calcium gluconate  Calcium channel blocker toxicity counteracting the dangerous effects on the heart, hydrofluoric acid burns

Chelators such as EDTA, dimercaprol (BAL), penicillamine, and 2,3-dimercaptosuccinic acid (DMSA, succimer.  Heavy metal poisoning

Cyanide antidotes (hydroxocobalamin, amyl nitrite, sodium nitrite, or thiosulfate) Cyanide poisoning

Cyproheptadine   Serotonin syndrome

Deferoxamine mesylate Iron poisoning

Digoxin Immune Fab antibody Digoxin poisoning, Oleander ingestion 

Diphenhydramine hydrochloride and benztropine mesylate Extrapyramidal reactions associated with antipsychotics

100% Ethanol or fomepizole   Ethylene glycol poisoning and methanol poisoning

Flumazenil   Benzodiazepine overdose, reversing the sedative effects of these medications

100% oxygen or hyperbaric oxygen therapy (HBOT) Carbon monoxide poisoning and cyanide poisoning

Idarucizumab Reversal of dabigatran etexilate, an anticoagulant

Insulin + Glucagon Beta blocker poisoning and calcium channel blocker poisoning

Leucovorin     Methotrexate, trimethoprim and pyrimethamine overdose

Intralipid Local Anesthetic toxicity

Methylene blue Treatment of conditions that cause methemoglobinemia

Naloxone hydrochloride Opioid overdose, reversing the effects of opioids and improving breathing.

N-acetylcysteine Paracetamol (acetaminophen) poisoning

Octreotide Oral hypoglycemic agents

Pralidoxime chloride (2-PAM) When given with Atropine: Organophosphate insecticides, nerve agents, some poison mushrooms

Protamine sulfate Heparin poisoning

Prussian blue Thallium poisoning

Physostigmine sulfate -Anticholinergic poisoning

Pyridoxine-Isoniazid poisoning, ethylene glycol, accidental hydrazine exposure 

Phytomenadione (vitamin K) and fresh frozen plasma for Warfarin overdose and some rodenticides

Sodium bicarbonate-Aspirin, TCAs with a wide QRS

I.V Silibinin-Amatoxin ingestion

Succimer, Dimercaptosuccinic acid (DMSA) Lead poisoning

Vitamin K: Used as an antidote for anticoagulant overdose, promoting blood clotting.

Digoxin immune fab (Digibind): Used as an antidote for digoxin overdose, binding to the digoxin and preventing its toxic effects.

Pralidoxime: Used as an antidote for organophosphate poisoning, reversing the effects of certain insecticides or nerve agents.

Protamine sulfate: Used as an antidote for heparin overdose, neutralizing the anticoagulant effects of heparin.

Dimercaprol (BAL): Used as an antidote for heavy metal poisoning, such as lead, mercury, or arsenic.

Idarucizumab Dabatigatran bleeding reversal

Idarucizumab-Apixaban and Rivaroxaban reversal

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