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Toxidromes and Antidotes

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tusoyozu's version from 2015-12-23 14:35

Antidotes

Question Answer
Antidote: acetaminophenacetylcysteine
Antidote: CCBCalcium chloride 10% or calcium gluconate 10%, glucagon
Antidote: hyperMgCalcium chloride 10% or calcium gluconate 10%
Antidote: hypoCacalcium chloride 10% or calcium gluconate 10%
Antidote: Cyanideamyl nitrate, sodium nitrite, sodium thiosulphate, hydroxycobalamin
Antidote: Hydrogen sulfideSodium nitrite
Antidote: IronDeferoxamine
Antidote: DigoxinDigoxin Fab (digibind)
Antidote: Ethylene glycolethanol, fomepizole
Antidote: Methanolethanol, fomepizole
Antidote: methotrexatefolic acid
Antidote: benzodiazepinesflumazenil
Antidote: BBglucagon
Antidote: nitroprussidehydroxocobalamin
Antidote: bupivocaineIV lipid emulsion 20%
Antidote: nitritesmethylene blue
Antidote: methemoglobinemiamethylene blue
Antidote: oral hypoglycemic agentsglucose, octreotide if refractory
Antidote: clonidinenaloxone
Antidote: anticholinergic agentsphysostigmine
Antidote: nicotinic cholinergic agentspralidoxime
Antidote: muscarinic cholinergic agentsatropine
Antidote: heparinprotamine
Antidote: isoniazidpyridoxine
Antidote: sodium-channel blockersodium bicarbonate
Antidote: Wernicke syndromethiamine
Antidote: dystoniabenztropine
Antidote: phenobarbitalurinary alkalinization
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Doses

Question Answer
Peds dose: naloxone0.01mg/kg IV
Peds dose: glucose0.5g/kg IV
Dose: activated charcoal50-100g po
Dose: Antivenom Fab4-6 vials IV over 1 hr, then repeat prn
Dose: Dextrose1g/kg IV
Peds dose: flumazenil0.01mg/kg IV
Dose: flumazenil3-10mg IV
Dose: IV lipid emulsion 20%100cc bolus, then 400cc over 20 mins
Dose: protamine1mg neutralizes 100 units UFH
Dose: pyroxidinegram for gram of isoniazid
Dose: sodium bicarbonate1-2mEq/kg IV bolus
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Toxidromes

Question Answer
Causes: sympathomimetic toxidromecocaine, amphetamine
Causes: cholinergic toxidromeorganophosphate insecticides, carbamate insecticides
Causes: anticholinergic toxidromescopolamine, atropine
Causes: salicilate poisoningaspirin, oil of wintergreen
Causes: sedative-hypnotic toxidromebarbiturates, benzos
Hallucinogensphencyclidine, LSD, psilocybin, mescaline
Causes: serotonin syndromeSSRIs, Meperidine, dextromethorphan, MAOIs, ctricyclic antidepressants, amphetamines, tramadol
Causes: extramyramidal toxidromeantipsychotics
S/S: Opioid toxidromeCNS depression, miosis, resp depression, hypothermia, bradycardia
Which opioids don’t cause miosismeperidine, propoxyphene
S/S: Sympathomimetic toxidromeagitation, mydriasis, diaphoresis, tachycardia, htn, hyperthermia, seizures, rhabdo, MI
S/S: Muscarinic cholinergic toxidromesalivation, lacrimation, urination, diaphoresis, gastric emptying, bronchorrhea, bradycardia
S/S: Nicotinic cholinergic toxidromeMTWThF: miosis, tachycardia, weakness, hypertension, hyperglycemia, fasciculations
S/S: Anticholinergic toxidromeRed as a beet, dry as a bone, blind as a bat, mad as a hatter, hot as a hare
S/S: salicylatesalterned mental status, resp alkalosis, met acidosis, tinnitus, hyperpnea, tachycardia, diaphoresis, N/V
S/S: Serotonin sydromealtered mental status, increased miscle tone, hyperreflexia, hyperthermia
S/S: Extrapyramidal toxidromedystonia, torticollis, tremor, muscle rigidity, akathesia
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