toxicities and side effects Flashcards
acetaminophen antidote
give N-acetylcysteine. recall that tylenol toxicity is caused by damage from NAPQI, an acetaminophen metabolite. NAPQI depletes glutathione, the liver’s natural antioxidant (and damages liver cells directly). N-acetylcysteine replenishes glutathione
tx for AChE inhibitor and organophosphate toxicity
atropine followed by pralidoxime (pralidoxime regenerates AChE faster if given early)
amphetamine antidote
NH4Cl acidifies the urine and traps amphetamines in it- increases elimination
antimuscarinic/anticholinergic antidote
give physostigmine salicylate, and control hyperthermia
benzodiazepine antidote
flumazenil
antidote for copper, arsenic, gold
penicillamine (chelator agent in this context)
antidote for cyanide poisoning
nitrite and thiosulfate; hydroxocobalamin.
these help convert cyanide to methemoglobin. hydroxocobalamin combines with cyanide to form a less toxic chemical. cyanide inhibits complex IV of the electron transport chain
heparin antidote
protamine sulfate binds to heparin and inactivates it
iron antidote
deferoxamine and deferasirox
lead antidote
EDTA, dimercaprol, succimer, penicillamine. succimer is used in kids; EDTA and dimercaprol are first line treatments.
(remember lead poisoning: Lead lines on gingivae and metaphysis of long bones; encephalopathy and erythrocyte basophilic stippling; abdominal colic and sideroblastic anemia, foot and wrist Drop. )
mercury, arsenic, and gold antidote
dimercaporol
antidote for methanol, ethylene glycol
fomepizole (competitive inhibitor of alcohol dehydrogenase)
antidote for methemoglobin
methylene blue, vitamin C
remember that methemoglobin has an incr. affinity for oxygen and can cause tissue hypoxia by holding on too tightly to it. happens under oxidative stress when Fe 2+ –> Fe3+. chocolate colored blood. methylene blue decreases helps reduce the Fe3+
opioid antidote
naloxone
sialicylate antidote
NaHCO3 to alkalize the urine
