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Overview of the most common antidotes and their indications
Antidote |
Indication |
Activated charcoal (Carbo medicinalis) |
Non-specific binding of fat- and water-soluble toxins (suspension of 30-50 g in approx. 300 ml p.o., children half) |
Antidotum universale (2 parts activated charcoal, 1 part tannic acid, 1 part Magnesia usta) |
Sublimate poisoning |
Apomorphine hydrochloride |
Inducing vomiting (as a mixed injection with Novadral), heroin, opiate addiction. |
Aquocobalamin acetate (Vit. 12a) |
Immediate treatment of hydrocyanic acid poisoning |
Atropine sulfate |
Acetylcholinesterase inhibitor (alkyl phosphate, carbamate poisoning) |
Bentonite |
Herbicides of the bipyridylium group (50 g suspended in 500 ml NaCl 0.9% p.o.) |
Berlin blue (ferric hexacyanoferrate(II)) |
Thallium poisoning (3 g p.o., exchanges cations for Tl at the surface) |
Bolus alba |
Adsorbent for basic substances (alkaloids) |
Calcium edetate sodium |
Lead, chromium, cobalt, vanadium, zinc, cadmium, radioactive metals |
Calcium salts (gluconate, lactate) |
Fluorides, oxalates, allergies (primrose, thymol, Hg compounds), also p.o. |
Calcium trisodium DTPA |
Lead |
Desferrioxamine mesylate |
Iron |
Digitalis antitoxin (Fab antibody) |
|
Dimaval (DMPS) |
Chronic poisoning with organ. and inorgan. Mercury compounds, lead compounds, arsenic, copper |
4-DMAP (4-dimethylamino-phenol) |
Hydrocyanic acid, cyanides |
DTPA-calcium-trinatrium salt |
Lead |
Defoamers (Sab simplex, Lefax) |
After ingestion of foaming agents (detergents, dishwashing liquids, etc.) 5 tsp Sab simplex, children 1 tsp |
Acetic acid |
Caustic burns (internal, diluted), lung irritation by ammonia (inhalation) |
Ethanol (95%) |
Methanol (adjust blood level to 1 per mille), ethylene glycol, low molecular weight glycols |
Flumazenil (Anexate) |
Benzodiazepines |
Folic acid (Folsan) |
Methanol |
Folinic acid (Leucovorin) |
MTX poisoning, critical decrease of leukocytes under MTX therapy |
Ethylene glycol poisoning; methanol poisoning |
|
Glucose 40% |
Insulin, sulfonylurea |
Hexamethylenetetramine |
Phosgene |
Ipecacuana syrup (vomit-inducing syrup NRF). |
To induce vomiting: From 5 yr, 30 ml Orpec p.o., up to 1.5 yr, 10 ml, up to 5 yr, 15 ml |
Junik metered dose aerosol 100 μg. |
Toxic pulmonary edema |
Potassium hexacyanoferrate(II) |
Copper salts: 0.6 g in water, 0.1% for gastric lavage |
Potassium iodide |
Thallium: 1% p.o., formation of TII, TIII3 |
Potassium permanganate |
Alkaloids: 0.1% p.o. |
Kelocyanor (Co2-EDTA) |
Hydrocyanic acid |
Magnesia usta (MgO) |
Acid binder (50 g/500 ml water p.o.) |
Macrogol 4000 |
see below for polyethylene glycol 400 |
Metalcaptase (D-penicillamine) |
Heavy metal poisoning (copper, lead, mercury, zinc, gold, cobalt) |
Methionine |
Paracetamol |
Naloxone (Naloxone, Naloselect) |
Respiratory depression in opiate, analgesic, ethanol or benzodiazepine intoxication |
N-acetylcysteine (Fluimucil Antidote) |
Paracetamol |
Sodium bicarbonate |
Metaldehyde, methanol, poisoning by tricyclic antidepressants: 200 ml 5% solution p.o. or in metabolic acidosis i.v. |
Sodium iodide |
Thallium: gastric lavage with 1% solution |
Sodium sulfate (Glauber's salt) |
Laxative: 1 tbsp. in 1 glass of water, children 1 tsp. in 1 glass of water |
Sodium thiosulfate |
Hydrogen cyanide: CN- is converted to SCN- in the body |
Obidoxime (Toxogonin) |
Phosphoric acid ester |
Kerosene. subliquid. |
Fat-soluble toxins: Removes them by dissolving them in the gastrointestinal tract, 200 ml p.o., children 50-100 ml p.o. |
Polyethylene glycol/macrogol 4000 (Laxofalk). |
External poisoning by, phenol, cresol, nitrobenzene, aniline, possibly in case of hydrofluoric acid burn: washing off of the corresponding skin areas. |
Physostigmine salicylate (anticholium) |
Anticholinergic syndrome. Poisoning with belladonna alkaloids, spasmolytics, anti-Parkinson drugs, antihistamines, etc. |
Quantalan (colestyramine) |
Digitalisin intoxication, Vit. K1 antagonists |
Toluidine blue |
Methemoglobin builders |
Trometamol (Tris-buffer, e.g. THAM) |
Severe metabolic acidosis, alkalinization in barbiturate and salicylate poisoning |
Vitamin K1 |
Vit. K1 antagonists (coumarin and derivatives) |