Liver antidotes

Since no specific antidotes are known, symptomatic therapy must be accompanied by complete rest. Toxicity by Inhalation (ThresholdUmit Value)-. 0.5 mg/m Short-Term Exposure Limits 2 mg/m for 30 min Toxicity by Ingestion oral LD, = 283 mg/kg (rat) Late Toxicity Possible liver damage loss of appetite or weight. Vapor (Gas) Irritant Characteristics No data Liquid or Solid Irritant Characteristics No data Odor Threshold No data. 

The nurse immediately reportsany signs of acetaminophen toxicity, such as nausea, vomiting, anorexia, malaise, diaphoresis abdominal pain, confusion, liver tenderness hypotension, arrhythmias jaundice, and acute hepatic and renal failure. Early diagnoss is important because liver failure may be reversible. Toxicity is treated with gastric lavage, preferably within 4 hours of ingestion of the acetaminophen. Liver function studiesare perform ed frequently. Acetylcysteine (Mucomyst) is an antidote to acetaminophen toxicity and acts by protect-... 

No specific antidote has been shown to be effective in treating 1,2-dibromoethane intoxication once absorption into the bloodstream has occurred (Ellenhorn and Barceloux 1988). Intravenous infusions of glucose may limit the hepatotoxicity of 1,2-dibromoethane (ERA 1989b). During the recovery phase, a diet rich in vitamin B and carbohydrates may limit liver damage (Dreisbach and Robertson 1987 Lawrence and Michaels 1984). Hemodialysis may be needed to regulate extracellular fluid and electrolyte balance and to remove metabolic waste products if renal failure occurs (ERA 1989b). 

DETAILS - The toxicity of certain amanita mush rooms has been well known for centuries. The main toxic species in the United States are Amanita phalloides (Deathcupor Destroying Angel), A. verna, and A. virosa. They contain a mixture of the toxins amanitin, phallpidm, and phalloin. Heat weakens or destroys the toxins, as evidenced by the fact that fresh pressed Amanitajuice is three times more toxic than the boiled juice. There is no antidote for these toxins -treatment is largely symptomatic. The liver is the main target ana is virtually destroyed upon short... 

Relative importance of covalent binding and lipid peroxidation in carbon tetrachloride-induced liver toxicity role of cell calcuim, protein and phospholipid degradation development of treatments/ antidotes. 

Cyanide poisoning poses some risk however, this is minimized both by the kinetic inertness of both Fe and Fe " cyano complexes and the high affinity of these ions for cyanide ([Fe"(CN)6] , fi6 10 [Fe "(CN)6] , Bg 10 [7, 35]. Small amounts of cyanide, which are released by photolysis and reduction products of nitroprusside, can usually be metabolized in the liver and kidneys by the enzyme rhodanase, which converts CN" to SCN [7, 36]. Cyanide can also be taken up by hydroxocobalamin to generate cy-anocobalamin (B12). As the conversion of cyanide to thiocyanate is dependent on the availability of sulfur, thiosulfate can be administered as an antidote [37]. Monitoring thiocyanate levels as an indicator of cyanide toxicity is no longer routine, but is done on patients with severe hepatic compromise who have been... 

N-acetyl-cysteine, a synthetic precursor of cysteine, is commonly used as an antidote to paracetamol-induced liver damage... 

Ethanol Multiple effects on neurotransmitter receptors, ion channels, and signaling pathways Antidote in methanol and ethylene glycol poisoning Zero-order metabolism duration depends on dose Toxicity Acutely, CNS depression and respiratory failure chronically, damage to many systems, including liver, pancreas, GI tract, and central and peripheral nervous systems Interactions Induces CYP2E1 Increased conversion of acetaminophen to toxic metabolite... 

Although milk thistle has not been confirmed as an antidote following acute exposure to liver toxins in humans, parenteral silybin is nevertheless marketed and used in Europe as an antidote in Amanita phalloides mushroom poisoning. This use is based on favorable outcomes reported in case-control studies. 

Side-effects are rare and may include hematological reactions, leucopenia, agranulocytosis and other hypersensitivity reactions. Paracetamol has a narrow therapeutic dose range and overdosage induces severe liver and renal damage (Lewis and Paloucek, 1991) via accumulation of a toxic metabolite, N- acetyl-benzoquinoneimine (NABQI). Acetylcysteine or methionine, which increase glutathione conjugation of the metabolite, are used as the antidote. 

Acetaminophen is ordinarily safe at the recommended dosages, but large amounts exhaust the reserve of glutathione and may cause fatal liver damage. By 1989, more than 1000 cases of accidental or intentional (suicide) overdoses had been reported with many deaths. Prompt oral or intravenous administration of N-acetylcysteine over a 72-hour period promotes synthesis of glutathione and is an effective antidote.)... 

The same mushrooms contain several fast-acting toxic heptapeptides, the phalloidins, whose structures are similar to those of the amanitins. However, they contain a reduced sulfur atom (—S—) in the cross-bridge. They are specifically toxic to the liver.c The same mushrooms also contain an antidote to the phalloidins, antamanide. This cyclic... 

Milk thistle has been used to treat acute and chronic viral hepatitis, alcoholic liver disease, and toxin-induced liver injury in human patients. Milk thistle has most often been studied in the treatment of alcoholic hepatitis and cirrhosis. In both of these disorders, outcomes have been mixed and reports include significant reductions in markers of liver dysfunction and in mortality, as well as no effect. In acute viral hepatitis, studies have generally involved small sample sizes and have shown mixed outcomes of improved liver function (eg, aminotransferase values, bilirubin, prothrombin time) or no effect. Studies in chronic viral hepatitis and toxin-induced injury have also been of small size but have reported mostly favorable results. Parenteral silybin is marketed and used in Europe as an antidote in Amanitaphalloides mushroom poisoning, based on favorable outcomes reported in case-control studies. 

This reaction is catalyzed by rhodanase enzyme, also called mitochondrial sulfur transferase. Although not found in the blood, this enzyme does occur abundantly in liver and kidney tissue. Because of this reaction, thiosulfate can be administered as an antidote for cyanide poisoning. 

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