Antidotes anticonvulsants

For this, antidotic formulas are supplemented with anticonvulsants of different chemical structures (diazepam, clonazepam, phenazepam, etc.). 

Temazepam (Restoril) [C-IV] [Sedative/Hypnotic/ Benzodiazepine] Uses Insomnia, anxiety, depression, panic attacks Action Benzodiaz ine Dose 15-30 mg PO hs PRN X in elderly Caution [X, /-] Potentiates CNS dqjressive effects of opioids, barbs, EtOH, antihistamines, MAOIs, TCAs Contra NAG Disp Caps SE Confusion, dizziness, drowsiness, hangover Interactions T Effects W/ cimetidine, disulfiram, kava kava, valerian T CNS depression W/ anticonvulsants, CNS depressants, EtOH t effects OF haloperidol, phenytoin X effects W/ aminophylline, dyphylline, OCPs, oxtriphylline, rifampin, theophylline, tobacco X effects OF levodopa EMS Use caution w/ other benzodiazepines, antihistamines, opioids and verapamil, can T CNS depression concurrent EtOH can T CNS depression abruptly D/C after >10 d use may cause withdrawal OD May cause profound CNS depression, confusion, bradycardia, hypotension, and altered reflexes flumazenil can be used as antidote, activated charcoal may be effective... 

O2, IV fluid, pressors, cyanide antidote kit, Cyanokit, sodium bicarbonate, anticonvulsants for Szs O2, charcoal, atropine (bradycardia), antiar-rhythmic (lidocaine, amiodarone)... 

The nonspecific antidotes are also given, for example anticonvulsants in convulsions. 

General supportive care should be provided. Aggressive gut decontamination should be carried out using repeated doses of activated charcoal and whole bowel irrigation. Propranolol or other blockers (eg, esmolol) are useful antidotes for B-mediated hypotension and tachycardia. Phenobarbital is preferred over phenytoin for convulsions most anticonvulsants are ineffective. Hemodialysis is indicated for serum concentrations greater than 100 mg/L and for intractable seizures in patients with lower levels. 

Conventional anticonvulsants (e.g., diazepam, phenobarbital, and phenytoin) may be administered to treat pyriminil-induced seizures. Niacinamide has been demonstrated to be an effective antidote in pyriminil poisoning in rats but little information is available regarding its antidotal efficacy in humans. Insulin therapy could be instituted as a preventive measure for possible diabetes mellitus. Orthostatic hypotension due to pyriminil exposure may be treated with conventional mineralocorticoids. 

In the field hospital the patients were treated with antidotal therapy (Atropine sulfate), oxime therapy (HI-6 or Pralidoxim), anticonvulsive therapy (Diazepam) and other supportive treatment such as ventilatory support. Victim with serious symptoms like unconsciousness, fasciculation, miosis, uncontrolled urination and defecation, severe dyspnea, convulsions and flaccid paralysis were immediately lifted in Zadar hospital. 

Convulsions are among the most severe symptoms of intoxication with high toxic OPC. The reduction of central convulsive syndrome exerts positive effect on both the course of OPC intoxication and the delayed consequences. For this, antidotic formulas are supplemented with anticonvulsants of different chemical structures (diazepam, clonazepam, phenazepam, etc ). Anticonvulsants facilitate normalization of metabolism of biogenic amines and CNS uptake of glucose, whose consumption grows up steeply in poisonings with soman [92]. 

Efficacy of the anticonvulsant usage in antidotic formulas depends considerably on OPC type. Thus, index of protection (IP) for the composition of ChR (HI-6 inclusive), cholinolytics and diazepam is much higher for the treatment of intoxication with soman and tabun, than in poisonings with sarin and VX [93],... 

At present, professional toxicologists should determine more clearly a range of neurotoxicants, which can be used with maximal probability in terrorist acts, and concentrate their efforts on the development of combined antidotic means composed of ChR and cholinolytics (or agents possessing concurrently reactivating and cholinolytic activities), anticonvulsants and reversible AChE inhibitors. 

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