Clinical toxicology antidotes

A. Picchioni and L, Chin, "The Antidotal Properties of a Super-Active Charcoal," presented at the Annual Meeting of American Association of Poison Centers-American Academy of Clinical Toxicology, Salt Lake City, August 5, 1981. (Being submitted for publication to the Journal of Clinical Toxicology.)... 

Human Toxicity Excessive doses may cause mercury poisoning. Antidote Dimercapro] (BAL). Caution If taxation from oral mercurous chloride should not occur, saline laxative must be administered to prevent possibility of mercury poisoning, cf Clinical Toxicology of Commercial Products, R. E. Gosselin et al, Eds. (Williams Wilkins, Baltimore, 4th ed., 1976) Section II, p 95. 

Hume AS, Mozingo JR, McIntyre B, Ho IK. 1995. Antidotal efficacy of alpha-ketoglutaric acid and sodium thiosulfate in cyanide poisoning. Journal of Toxicology and Clinical Toxicology 33 721-724. 

Skolfield S, Lambert D, Tomassoni A, Wallace K. 1997. Inadequate regional antidote and medication supplies for poisoning emergencies. Clinical Toxicology 35 490. 

Ten Eyck RP, Schaerdel AD, Lynett JE, et al. 1983. Stromafree methemoglobin solution as an antidote for cyanide poisoning A preliminary study. Journal of Toxicology and Clinical Toxicology 21 343-358. 

In the management of an opiate knockdown agent exposure, early airway and ventilation assessment is essential and intermittent positive pressure ventilation with 100 % oxygen should start as soon as possible if there is a respiratory failure. An antidote to the respiratory depression caused by opiates is naloxone which is used both in anaesthetic and clinical toxicological practice. This is given in doses of 0.4 mg IV repeated until there is a reversal of the respiratory depression. It should be noted that in cases of mixed injury where opioids may have been given for pain relief, the analgesic effect will also be reversed. 

Marrs, T.C. 1987. The choice of cyanide antidotes. Pages 383-401 in B. Ballantyne and T.C. Marrs (eds.). Clinical and Experimental Toxicology of Cyanides. Wright, Bristol. 

Toxicology is an interesting medical discipline. The principles of management are prevention, toxicovig-ilance and careful assessment of the clinical features of the poisoned patient, and providing timely and appropriate therapy. In most cases, these are symptomatic and supportive measures, on top of decontamination, elimination of the poison, and provision of specific antidotes. 

Eyer, P., Szinicz, L., Thiermann, H., Worek, F., Zilker, T. (2007). Testing of antidotes for organophosphoms compounds experimental procedures and clinical reality. Toxicology 233 108-19. 

Severe and medium severe cases can be treated at the toxicology, internal and child wards and clinics. Application of detoxic depuration, antidote, organ-protective, symptomatic treatment is undertaken. Upon indications - reanimation as well. 

---