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Pharm antidotes

Day 6

QuestionAnswer
acetaminophen (toxic dose=4g/day) N-acetylcysteine
How does N-acetylcysteine treat acetaminophen toxicity (2 parts)? Provides sulfhydryl groups and act as as a glutathione substitute that binds the toxic metabolite
amphetamines NH4Cl (ammonium chloride); amphetamines are basic, so need to acidify the urine to trap them
salicylates NaHCO3 (sodium bicarb); salicylates like aspirin are acidic so need to alkanize the urine to trap them
AChE inhibitors, organophosphates atropine and pralidoxime (regenerates AChE)
Antimuscarininc, anticholinergic (e.g., atropine) Physostigmine (anticholinesterase) salicylate
Beta blockers Glucagon, calcium, and atropine
Verapamil Glucagon, calcium, and atropine
Digitalis Stop dig, normalize K, lidocaine, anti-dig Fab fragments, Mg
Iron Deferoxamine (Fe=iron, De=away--> makes iron go away)
Lead CaEDTA, dimercaprol, succimer (kids), penicillamine
Mercury DiMERcaprol (BAL), succiMER (MER for MERcury)
Arsenic Dimercaprol, succimer, and penicillamine
Gold DIMErcaprol, succimer, and PENICillamine (DIMEs and PENIC/pennies are as good as gold)
Copper PENICillamine (PENIC/pennies are made of copper)
Cyanide (house fires) Nitrite, hydroxocobalamin, thiosulfate (can't use O2!)
Methemoglobin Methylene blue, vitamin C
Carbon monoxide 100% O2, hyperbaric O2
Toxicity causes metabolic acidosis and retinal damage Methanol
Toxicity causes metabolic acidosis and nephrotoxicity via calcium oxalate crystal deposition in the nephron Ethylene glycol (antifreeze)
Methanol Ethanol, dialysis, fomepizole (fewer SE than ethanol)
Ethylene glycol (antifreeze) Ethanol, dialysis, fomepizole (fewer SE than ethanol)
What is the mechanism of action of fomepizole? Competitive inhibitor of alcohol dehydrogenase; prevents breakdown of methanol and ethylene glycol into toxic metabolites
Opioids Naloxone/naltrexone (babies in opioid withdrawl may be given tincture of opium)
Benzos Flumazenil
What is the mechanism of action of flumazenil? competitive inhibitor of the benzo binding site on the GABA-A receptor
TCAs NaHCO3 (alkaline the plasma)
Heparin PROtamine (H like a PROton)
Warfarin Vitamin K and fresh, frozen plasma
tPA (tissue plasminogen activator) Aminocaproic acid
Streptokinase Aminocaproic acid
What is the mechanism of action of aminocaproic acid? Inhibits proteolytic enzymes; a lysine analog
Theophylline Beta blocker
What are the signs and symptoms of lead poisoning? Anemia, Basophilic stippling, Colicky pain, Diarrhea, Encephalopathy, Foot drop, and Gums (Burton's lead lines)= ABCDEFG
Created by: sarah3148