TOXICOLOGY
TABLE 6.25. Antidotes for Specific Toxicologic Agents
ANTIDOTE INGESTION/EXPOSURE INDICATIONS FORTREATMENT
Atropine Cholinergic poisoning Symptomatic bradycardia
Excessive secretions
Black widow spider Black widow spider Persistent symptoms despite analgesia
antivenom (Latrodectus) Pregnancy
Very young or elderly
Calcium Hydrofluoric (HF) acid exposure Local symptoms or burns (dermal application)
Hypocalcemia or high-concentration exposure (IV dosing)
CroFab Family Viperidae: Progressive swelling
Rattlesnakes Increased pain
Copperheads Coagulopathy
Water moccasins Systemic symptoms
Cyanide antidote kit Cyanide Suspicion for exposure in patients with acidosis coma,
seizures, and hypotension
Deferoxamine Acute iron intoxication Systemic symptoms
Iron level >500 mcg/dL
Digoxin-specific Fab Digoxin toxicity Ventricular dysrhythmias
Bradycardia unresponsive to therapy
K > 5.0 mEq/dL in acute ingestion
Potentially massive overdose
Flumazenil Benzodiazepine overdose Severe respiratory depression
Contraindicated in: chronic use; if coingestion of
seizure-inducing medication; elevated ICP
Fomepizole Ethylene glycol Metabolic acidosis or known ingestion of a toxic alcohol
Methanol
Glucagon Ca++channel blocker toxicity Symptomatic bradycardia
β-Blocker toxicity Hypotension
Hydroxocobalamin Cyanide Suspicion of exposure in patients with acidosis coma,
seizures, and hypotension
Insulin/glucose Ca++channel blocker toxicity Symptomatic bradycardia
β-Blocker toxicity Hypotension
Methylene blue Methemoglobinemia Levels >30%
Mental status changes
Chest pain
Shortness of breath