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Antidotes
By
Ms.Preeti
SMVDCoN
• According to WHO “Antidote was defined as a
therapeutic substance used to counteract the
toxic action(s) of a specified xenobiotic.”
• Antidotes reduce the overall burden of health
service in managing of poisoning cases
INTRODUCTION
• An antidote is a substance thatcan
counteract a form of poisoning.The
term ultimately derives from the
Greek term (pharmakon) antidoton,
"(medicine) given as aremedy".
• Antidotes for anticoagulants are
sometimes referred to asreversal
agents.
INTRODUCTION
• The antidotes for some particular toxins are
manufactured by injecting the toxin into an animal in
small doses and extracting the
resulting antibodies from the host animals' blood. This
results in an antivenom that can be used to
counteract venom produced by certain species of
snakes, spiders, and other venomous animals. Some
animal venoms, especially those produced by
arthropods (e.g., certain spiders, scorpions, bees, etc.)
are only potentially lethal when they provoke allergic
reactions and induce anaphylactic shock; as such,
there is no "antidote" for these venoms because it is
not a form of poisoning and anaphylactic shock can
be treated (e.g., by the use ofepinephrine).
ANTIDOTES
Supportiv
e therapy
Correc
t
antidot
e
1
Patient
surviva
l
CLASSIFICATION OF ANTIDOTE
• According to mode of Action:
Physic
al
Chemica
l
Physiological/
pharmacological
Physical Antidote:
• Agent use to interfere with poison
through physical properties, not
change their nature.
• a) Adsorbing: The main example is
activated charcoal.
• b) Coating: A mixture of egg & milk
make a coat over the mucosa.
• c) Dissolving: 10% alcohol or
glycerin for carbolic acid
Chemical Antidote:
Interact specifically with a toxicant,
or neutralize the toxicant. e.g.
metal chelators combine with
metals to form complexes that can
then be eliminated by the kidneys
Mainly act by twomechanisms:
Complex Formation: Antidote
make complex with the toxicant
making it unavailable to cross the
membrane or to interact with
receptors.
DMSA(dimercaprol and
dimercaptosuccinic acid are
sulfohydral compounds that bind
metal such as arsenic acid,lead.
Pharmacological antidote
counteract the effects of a
poison by producing the
opposite pharmacological
effects, e.g., ACHE
inhibitors,atropine.
•Pharmacologic antidotes
may neutralize or
antagonize the effects of a
toxicant.
•This type of antidote may
act by following 5
mechanism.
Some specific Antidotes for drugs and
chemicals
S.No. Agent causing toxicity Antidotes Dose
1. Paracetamol N-acetyl cysteine Oral =140mg/kg followed
by 70mg/kg even 4hrs,or
IV 150mg/kg infusion
over 15min. Repeated as
required.
2. Morphine andother
opoids
naloxone 1-2mg IV repeatedevery
10-15 minutes
3. heparin Protamine
sulphate
1mg iv for every100units
of heparin
4. cyanide sodium nitrate+
Sodium
thiosulfate
10 ml of 3% solutionIV
50 ml of 25% solution iv
Some specific Antidotes for drugs and
chemicals
S.No. Agent causing toxicity Antidotes Dose
5. Copper D-penicillamine 100mg/kg/day orally in 4
divided dose for 3-7 days
6. Iron Desferrioxamine 15mg/kg/hour IV
7. Arsenic Dimercaprol 1st day 400-800 mg deep
IM in divided dose 2nd and
3rd day 200-400mg.4th day
onwards 100-200mg.
8. Led calcium
disodium edetate
1 gram in 250mlsaline
infusion twice aday
Some specific Anidotes for drugs and chemicals
S.No. Agent causing toxicity Antidotes Dose
9. Insulin Glucose 50ml of 50% solution
10. Mathanol, ethylene
glycol
Ethanol 10% ethanol is givenorally
11. Carbon monoxide Oxygen 100% by high flownon-
rebreathing mask
12. Nitrites Methyline blue 0.1% solution slow IV in
the dose of 1-2 mg/kg
body weight
Some specific Antidotes for drugs and chemicals
S.No. Agent causing toxicity Antidotes Dose
13 Warfarin Vitamin K 1 oxide 10mg IM followed by 5mg 4
hrly asrequired
14 Benzodiazepines Flumazenil 0.2 mg IV repeatedas
required (max. 3mg)
15. Caffeine Esmolol 25-50µ/kg/min-IV
16. Atropine physostigmine 1-2mg IV slowly may be
repeated if symptoms re-
appear.
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Antidotes for Poisoning: Types, Mechanisms and Specific Examples

  • 2. • According to WHO “Antidote was defined as a therapeutic substance used to counteract the toxic action(s) of a specified xenobiotic.” • Antidotes reduce the overall burden of health service in managing of poisoning cases
  • 3. INTRODUCTION • An antidote is a substance thatcan counteract a form of poisoning.The term ultimately derives from the Greek term (pharmakon) antidoton, "(medicine) given as aremedy". • Antidotes for anticoagulants are sometimes referred to asreversal agents.
  • 4. INTRODUCTION • The antidotes for some particular toxins are manufactured by injecting the toxin into an animal in small doses and extracting the resulting antibodies from the host animals' blood. This results in an antivenom that can be used to counteract venom produced by certain species of snakes, spiders, and other venomous animals. Some animal venoms, especially those produced by arthropods (e.g., certain spiders, scorpions, bees, etc.) are only potentially lethal when they provoke allergic reactions and induce anaphylactic shock; as such, there is no "antidote" for these venoms because it is not a form of poisoning and anaphylactic shock can be treated (e.g., by the use ofepinephrine).
  • 6. CLASSIFICATION OF ANTIDOTE • According to mode of Action: Physic al Chemica l Physiological/ pharmacological
  • 7. Physical Antidote: • Agent use to interfere with poison through physical properties, not change their nature. • a) Adsorbing: The main example is activated charcoal. • b) Coating: A mixture of egg & milk make a coat over the mucosa. • c) Dissolving: 10% alcohol or glycerin for carbolic acid
  • 8. Chemical Antidote: Interact specifically with a toxicant, or neutralize the toxicant. e.g. metal chelators combine with metals to form complexes that can then be eliminated by the kidneys Mainly act by twomechanisms: Complex Formation: Antidote make complex with the toxicant making it unavailable to cross the membrane or to interact with receptors. DMSA(dimercaprol and dimercaptosuccinic acid are sulfohydral compounds that bind metal such as arsenic acid,lead.
  • 9. Pharmacological antidote counteract the effects of a poison by producing the opposite pharmacological effects, e.g., ACHE inhibitors,atropine. •Pharmacologic antidotes may neutralize or antagonize the effects of a toxicant. •This type of antidote may act by following 5 mechanism.
  • 10. Some specific Antidotes for drugs and chemicals S.No. Agent causing toxicity Antidotes Dose 1. Paracetamol N-acetyl cysteine Oral =140mg/kg followed by 70mg/kg even 4hrs,or IV 150mg/kg infusion over 15min. Repeated as required. 2. Morphine andother opoids naloxone 1-2mg IV repeatedevery 10-15 minutes 3. heparin Protamine sulphate 1mg iv for every100units of heparin 4. cyanide sodium nitrate+ Sodium thiosulfate 10 ml of 3% solutionIV 50 ml of 25% solution iv
  • 11. Some specific Antidotes for drugs and chemicals S.No. Agent causing toxicity Antidotes Dose 5. Copper D-penicillamine 100mg/kg/day orally in 4 divided dose for 3-7 days 6. Iron Desferrioxamine 15mg/kg/hour IV 7. Arsenic Dimercaprol 1st day 400-800 mg deep IM in divided dose 2nd and 3rd day 200-400mg.4th day onwards 100-200mg. 8. Led calcium disodium edetate 1 gram in 250mlsaline infusion twice aday
  • 12. Some specific Anidotes for drugs and chemicals S.No. Agent causing toxicity Antidotes Dose 9. Insulin Glucose 50ml of 50% solution 10. Mathanol, ethylene glycol Ethanol 10% ethanol is givenorally 11. Carbon monoxide Oxygen 100% by high flownon- rebreathing mask 12. Nitrites Methyline blue 0.1% solution slow IV in the dose of 1-2 mg/kg body weight
  • 13. Some specific Antidotes for drugs and chemicals S.No. Agent causing toxicity Antidotes Dose 13 Warfarin Vitamin K 1 oxide 10mg IM followed by 5mg 4 hrly asrequired 14 Benzodiazepines Flumazenil 0.2 mg IV repeatedas required (max. 3mg) 15. Caffeine Esmolol 25-50µ/kg/min-IV 16. Atropine physostigmine 1-2mg IV slowly may be repeated if symptoms re- appear.