كل ال Antidote In Poisoning

ANTIDOTE AND OTHER SUBSTANCES USED IN POISONING

general care in poisoning includes :

1- respiration assistance reguired in uncnscious patient . assisted ventilaion.
2- blood pressure : hypotension is common in sever poisoning vasopressor drug shouldnot be used
3- heart :arrhythmia may ocure in acute poisoning

4- body temperature : hypothermia

5- convulsion : single short- lived convulsion do not require tretment
. if recur frequentiy diazepam 10mg by slow iv injection give

in addition it it important if possible to :

remove ingested poison from stomsch (gastric lavage , emiatcs

prevent absorption (adsorbentts

promot elmination of toxin

non specific

1- activater charcoal
2- ipecac

specific

1- acety cysteine
2- atropine
3- desferrioxamine
4-flumazenil
5- methylene blue
6- naloxone
7-neostigmine
8- obidoxime
9- penicillamine
10-calcium disodium edetate

ACTIVATED CHARCOAL

GENNERAL INFORMATION

Adsorbent

Adsorbs toxic substance of certain plant and drug and those produced by some microbes
Reduce the absorption of many poison. The sooner it is give the the more the effective it is.
Also used as an actived elimination technique : repeated dose of
activated charcoal by mounth rnhance the elimination of some drug after
they have been absorbed, by retaining them in the gastro intestinal
tract unit they aer elimination with faeces.

CLINICAL INFORMATION

Indication

1- intoxication after taking drug in higher doses than normal : used
successfully with aspirin, paracetamol , phenytoin and other drug.

2- poisoning by plant

Dosage and administration\

1- reducing absorption
Child: 25g adult : 50g

2-active elimination
Adult and child : 50g initially then repeat very 4hr if necessary

Administer the powder suspended in water.

Side effect and toxicity

Constipation
Black coloring of faeces

Pharmaceutical information

Powder activated charcoal

IPECAC ( USP ) = IPECACUANHA ( BP )

GENERAL INFORMATION

Emetic

In poisoning ipecacuanha is of very limit value , there is no evidence
that it prevent clinically significant absorption (even if used 1- 2 hr
)

CLINICALINFORMATION

Indication

Indication of emesis in selected pt who are fully conscious

Dosage and administration

Child 6 -8 months 10 ml old : 15 ml

Adult 30 ml

The dose is followed by glass of water and repeated after 20 min if necessary vomiting usually occure within half hour .

Side effects and toxicity

Excessive vomiting , mucosal damage

Drowsiness and diarrhea can occur

Cardiac effect if absorbed

Precaution

Avoid in poisoning with corrosive or petroleum product owing to risk of aspiration

Pharmaceutical infomatiom

Ipecac syrup

ATROPINE

GENERAL INFORMATION

Antispasmotic and parasympatholtic. Since atropine has antisecretory properties it is also used in pre-anesthesia medication.
Organophosphours insecticides are absorbed through the bronchi. Skin and gut.
They inhibit cholinesterase activity thereby prolonging and
intensifying the effect of acetylcholine. Atropine will reverse the mus
carinic effect of acety choline.

CLINICAL INFORMATION

Indication

- intoxication with organophosphorus insecticides.

Dosage and administration

- 2-4hr mg iv or im ( according to the severity of the poisoning)
injection every 10 -30 min. until sings of effect atropine appear (
dilatation of pupils , tachycardia develops , skin flushing )

Pharmaceutical information

Atropine sulphate 1mg 1ml ampules

[size=25]ACETYLCYSTEINE

GENERAL INFORMATION

Acetycystiene is antidote against paracetamol poisoning . it protect
the liver if give within 10 – 12 hr of paracetamol poisoning.

CLINICAL INFORMATION

Indication

Paracetamol overdoage

Dosage and administration

- by iv infusion in glucose 5% infusion . initially 150 mg / kg in 200 ml over 15 min.
Followed by 50 mg / kg in 500 ml over 4 hr. then 100 mg / kg in 1000 ml over 6 hr.
It is often wise to continue treatment for as long as 48 hr. but at lower dose

Side effect and toxicity

- rashes anaphlaxis.

PHARMACEUTICAL INFORMATIOM

ACETYCYSTEINE 20 % AMP

[/size]