Common antidotes

In developing countries that lack adequate facilities for intensive therapy of poisoned people, antidotes may be more essential in the prevention and treatment of poisoning. But availability of antidotes is different from one country to another. In developing countries, physicians reported difficulties in obtaining even common antidotes. Even in industrialized countries, could be noticed administrative difficulties and the lack of suitable drugs (pharmaceutical formulation, concentration etc.). 

Answer D. In addition to NO, metabolism of nitroprusside also releases small quantities of cyanide, a potent and potentially lethal inhibitor of cyt a/a (Complex IV). Thiosulfate is a common antidote for CN poisoning. 

I6I C. Warfarin baits need contain only 0 025% active principle, and rats are killed after ingesting about 5 doses the bait can be left down and the risk of acute toxicity to man or domestic animals is not serious. In common with other coumarin derivatives, warfarin reduces the clotting power of blood and death is caused by haemorrhages initiated by any slight injury. Warfarin is a vitamin K antagonist, and large oral doses of the vitamin can be given as an antidote. 

Effective antidotes for use in an emergency are not common. Examples include ... 

Therapeutic Function Cholinesterase reactivator (antidote for nerve gas) Chemical Name 2-[(Hydroxyimino)methyl] -1-methylpyridinium chloride Common Name 2-PAM chloride Structural Formula ... 

Therapeutic Function Antidote in heavy metal poisoning Chemical Name N-(2-Mercapto-1-oxopropyl)glycine Common Name Mercamidum... 

In rabbits under light amytal anesthesia, chlordan has no direcr effect on the blood pressure, but produces a type of respiration having many characteristics in common with Cheyne-Stokes type. The generalized tremors, opisthotonus, tonic and clonic convulsions, produced by chlordan were decreased or abolished and respiration restored to normal by suitable injections of the sodium salts of amytal, phenobarbital, and pentothal. The LD60 of chlordan, which was about 20 mg. per kg. on intravenous administration to intact rabbits, was increased to about 60 mg. per kg. through the antidotal action of the barbiturates. An unidentified chlorine-containing degradation product with acidic properties was recovered from the urine of rabbits treated with chlordan. Approximately one third of its chlorine content was set free on hydrolysis at 100° C. with sodium hydroxide in either absolute alcohol or in water. 

Particular aspect regards common drugs (active substance) used in therapy that could be used successfully as antidotes, but in different formula or concentration. In that condition additional authorization is... 

L-Cysteine is a high value a-amino acid used world-wide in a scale of 1200-15001 year-1 as additive in foodstuffs, cosmetics or as intermediate or active agent (as antidote to several snake venoms) in the pharmaceutical industry. Chemical routes generally lack the efficiency of electrochemical techniques, or they produce mixtures of l- and d- forms rather than the L-isomer. The most common electrochemical route is the cathodic reduction of L-Cystine in acid (usually HC1) solution to produce the stable hydrochloride. In Table 10, the charateristic data for a laboratory bench, laboratory pilot and a product pilot reaction using a DEM filter press are compared [13]. A production scale study was carried out in a filterpress reactor divided by a cation exchange membrane with a total area of 10.5 m2. The typical product inventory was 450 kg/24-hour batch time. For more details see Ref. [13]. 

Treatment of paracetamol overdose is based on replenishment of antioxidant thiols to supplement the role of glutathione the most commonly used antidote is N-acetyl cysteine, but is only effective if given within a particular time window after ingestion. 

In the search of antidotes for these cholinesterase inhibitors, oximates as well as hydrox-ylamines and hydroxamates have become paramount, since these are 100- or greater-fold more reactive under mild conditions than the common base, hydroxide Structures of commonly studied oximes including pyridinium aldoximes are given in Scheme 4. The pyridinium moiety confers advantages of solubility as well as in lowering the oxime pTsTa. thus effecting higher reactivity under milder conditions of pH. 

Note - It is a good idea to have a supply of cyanide antidote ready in case you are affected by the fumes. These are sodium thiosulfate, a common photographic chemical, and amyl nitrite, a heart drug. Butyl nitrite is available in some "sex" shops as a room odorant, and may be substituted for the amyl nitrite. A few hours before beginning production of the actual cyanide, take a capsule containing 500 mg of sodium thiosulfate. It is comparatively non-toxic, but may cause a small bout of "egg burps". 

Sodium thiosulfate is a common analytical reagent used in iodometric titration to analyze chlorine, bromine, and sulfide. Other uses are in bleaching paper pulp, bleaching straw, ivory, and bones, for removing chlorine from solutions, silver extraction from its ores, a mordant in dyeing and printing textiles, and as an antidote to cyanide poisoning. 

Acetaminophen (paracetamol) poisoning is common in Western countries and is increasing elsewhere. Single doses as low as 7.5 g in adults or 150 mg/kg in a child can cause severe toxicity. Very occasionally, lower doses cause harm. Mortality, from hepatic or occasionally renal failure, is related to blood concentration and the time between ingestion and the initiation of antidotal treatment. Even severely poisoned patients may be asymptomatic, although nausea and vomiting are fairly common. 

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