Antidotes/Interventions
Antidotes
What'd they take
Enhanced Elimination
Classic Presentations
100

First line treatment for cocaine chest pain

Benzodiazepines (NTG also acceptable)


100

Loading dose of N-Acetylcysteine (in mg/kg)

150 mg/kg

100

Bradycardia, hypotension, hypoglycemia.

beta blocker

100

Ingestion of extended release preparations, body packing, and heavy metal ingestion may all be indications for this enhanced elimination technique

Whole bowel irrigation

100

somnolent, miosis, Hypertension initially than hypotension, bradycardia

clonidine

200

3 interventions for severe calcium channel blocker toxicity

Calcium

Atropine

Vasopressors

High dose insulin

Lipid Emulsion

ECMO


200

Protamine

Heparin overdose

200

20 year old male with agitation, noted to be "picking at things in the air." His heart rate is 120 with blood pressure 145/90. Pupils are dilated. Dry Skin

Anticholinergic

Coricidin - acetaminophen/chlorpheniramine. (benadryl, hydroxyzine would also be acceptable)

200

Metformin toxicity causes severe lactic acidosis and tends to be responsive to this enhanced elimination technique

Hemodialysis

200

56 year old white male went to the barn to "work on the tractor." When he returned, he appeared intoxicated. pH is 7.02 with an anion gap metabolic acidosis on CMP and an osmolar gap of 35.

Fomepizole

300
Potential unique neuro effect of OD on tramadol (other than sedative hypnotic effects)

Seizures

300

1U/kg Insulin infusion (name 2)

Beta blocker (calcium channel blocker also acceptable, anesthetics)

300

64 year old female with history of congestive heart failure is found with pills around her bed. Atrial tachycardia with 3:1 block, narrow complex. Pulse 55. 

Digoxin

300

carbamazepine, phenobarbital, theophylline, salicylates may all be indications for this enhanced elimination technique

multi-dose activated charcoal

300

25 year old female with an unknown ingestion. She demonstrates altered mental status. Vs: p 110 bp 130/80 r 24 sao2 95% on ra. ABG: 7.36/26/113/18

Sodium Bicarbonate

400

Antidote for seizures related to False Morel ingestion

pyridoxine

400

Bromocriptine

Neuroleptic Malignant Syndrome

400

Pt.'s friend reports that they went clubbing and she suspects her friend may have used something. Physical exam reveals hyperreflexia, inducible clonus, and ocular clonus/rotatory nystagmus.

PCP

400

This enhanced elimination technique is used in mild to moderate severity salicylate toxicity (not hemodialysis)

Urinary alkalization

400

syncope after involvement in a structure fire. Lactate 10.

hydroxylcobalamine (amyl nitrate and sodium thiosulfate also acceptable)

500

Antidote for metabolic derangement associated with Valproic acid toxicity

L-carnitine

500

Name 4 substance that can be dialyzed

All toxic alcohols

Aspirin

Phenobarbital

Lithium

500

16 year old amish female presents with generalized weakness, mild confusion, dyspnea, and a bluish tint to the lips and skin. Pulse oximetry reveals an oxygen saturation of 85%.

Nitrates in well water causing methemoglobinemia

500

Sulfuryl fluoride poisoning antidote

Calcium

500

20 year old out clubbing, Altered mental status. Sodium= 118


Ecstasy (MDMA)

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