| Poison/syndrome | Antidote(s) | Adult dose |
| Acetaminophen | N-acetylcysteine (Mucomyst 20%) | Initial oral dose: 140 mg/kg, then 70 mg/kg q 4h x 17 doses |
| Anticholinergic agents | Physostigmine (Antilirium) | Initial dose: 0.5-2.0 mg slow IV over 3-5 min |
| Benzodiazepines | Flumazenil (Romazicon) | Initial dose: 0.1-0.2 mg IV over 30-60 sec, repeat 0.1-0.2 mg IV every minute prn up to 1.0 mg |
| Beta-blockers | 1) Glucagon | 1) Initial dose: 5-10 mg IV bolus, then 2-10 mg/hr IV infusion |
| 2) Calcium | 2) Calcium chloride 10%: 1 gm (10 cc) IV; repeat as necessary | |
| 3) Insulin + dextrose | 3) Insulin load: 0.5 units/kg IV bolus, then 0.5-1.0 U/kg/h IV Dextrose 10% IV infusion (with KCl) - titrate to euglycemia |
|
| Calcium-channel blockers | 1) Calcium | 1) Calcium chloride 10%: 1-4 gm (10-40 cc) IV; repeat as necessary |
| 2) Glucagon | 2) Initial dose: 5-10 mg IV bolus, then 2-10 mg/hr IV infusion | |
| 3) Insulin + dextrose | 3) Insulin load: 0.5 units/kg IV bolus, then 0.5-1.0 U/kg/h IV | |
| Carbon monoxide | Oxygen ± hyperbaric chamber | 100% oxygen by ventilator or NRB; high-flow oxygen by tight-fitting facemask |
| Coumarins | Vitamin K | 5-25 mg max 50mg parenteral vit K1. severe bleeding Fresh whole blood, fresh frozen plasma, commercial factor X. |
| Crotalid snakebite | Wyeth polyvalent crotalidae antivenin (equine) | Mild: 3-5 vials; moderate: 6-10 vials; severe: 10-20 vials Mix reconstituted antivenin in 1000 ml NS over 4-6 hours |
| Cyanide | 1) Amyl nitrate pearls | 1) One ampule by inhalation for 15 sec every 3 min until IV access |
| 2) Sodium nitrite (3% solution) | 2) 10 ml (300 mg) IV over 3 min | |
| 3) Sodium thiosulfate (25%) | 3) 50 ml (12.5 g) IV over 10 min | |
| Digoxin | Digoxin immune Fab (Digibind) | 1) (# mg ingested x 0.8) ÷ 0.6 = #vials needed |
| 2) (Dig concentration [in ng/ml] x 5.6 x kg [weight]) ÷ 600 = #vials | ||
| 3) Empiric dose: 10 vials (acute poisoning); 1-3 vials (chronic) | ||
| 4) Reconstitute Digibind in NS and administer IV over 5-30 min | ||
| Iron/ other heavy metals | Desferrioxamine, Deferasirox | |
| Isoniazid | Pyridoxine | |
Ethylene glycol Methanol |
1) Ethanol 10% in D5W ± hemodialysis | 1) Initial load: 10 ml/kg IV of 10% ethanol over 30 min, then 1.5 ml/kg IV infusion (titrate drip to serum ethanol 100 mg/dL); double to triple infusion during hemodialysis |
| 2) Fomepizole [4-MP] (Antizol) ± hemodialysis | 2) Initial load: 15 mg/kg IV over 30 min, then 10 mg/kg every 12 hours IV over 30 min (re-bolus during HD) | |
| Magnesium | Calcium gluconate | |
| Opioids | Naloxone | |
| Organophosphates | Atropine &
Pralidoxime |
Pralidoxime; Adult iv 2g initially then 500mg/hr iv infusion.
Child ; iv 50mg/kg initially then 20mg/kg/hr infusion. |
| Paracetamol | N-Acetyl cysteine | |
| Thalium | Prussian blue | |