An antidote is a substance that can counteract a form of poisoning. The term antidote is a Greek word meaning “given against”. This post will help you familiarize yourself with the common antidotes that are used in the hospital setting. The following are antidotes that should be familiarized by the nurse to respond to this emergency situation quickly.
Table of Antidotes
|Antidote||Indication||Mode of Action|
|acetylcysteine (Mucomyst)||Acetaminophen/ Tylenol/ Paracetamol||Restores depleted glutathione stores and protects against renal and hepatic failure.|
|Activated charcoal||Non-specific poisons except cyanide, iron, lithium, caustics and alcohol.||Absorption of drug in the gastric and intestinal tracts. Interrupts the entero-hepatic cycle with multiple dose.|
|albuterol inhaler, insulin & glucose, NaHCO3, kayexalate||Potassium|
|anticholinesterase agents||Neuromuscular blockade (paralytics)|
|atropine sulfate or pralidoxime||Anticholinesterase||Competitive inhibition of muscarinic receptors.|
|Benzylpenicillin||Amanita phalloides (Death cap mushroom)||Not known; partial protection against acute hepatic failure; may displace amatoxin from protein-binding sites allowing increased renal excretion; may also inhibit penetration of amatoxin to hepatocytes.|
|Calcium salts||Fluoride ingestion||Rapidly complexes with fluoride ion.|
|deferoxamine||Iron||Deferoxamine acts by binding free iron in the bloodstream and enhancing its elimination in the urine.|
digoxine immune fab
|Digoxin||Binds molecules of digoxin, making them unavailable for binding at their site of action on cells in the body.|
|dimercapol, edetate calcium, disodium,||Lead||Chelation of lead ions and endogenous metals (e.g., zinc, manganese, iron, copper).|
|diphenhydramine (Benadryl)||Extrapyramidal symptoms (EPS)||A potent antagonist to acetylcholine in muscarinic receptors.|
|flumazenil||Benzodiazepines||Reverses the effects of benzodiazepines by competitive inhibition at the benzodiazepine binding site on the GABAA receptor.|
|fomepizole||Ethylene glycol||A competitive inhibitor of the enzyme alcohol dehydrogenase found in the liver. This enzyme plays a key role in the metabolism of ethylene glycol and methanol.|
|glucagon||Beta blockers and calcium channel blockers||Stimulates the formation of adenyl cyclase causing intracellular increase in cycling AMP and enhanced glycogenolysis and elevated serum glucose concentration.|
|Glucose (Dextrose 50%)||Insulin reaction||Dextrose (the monosaccharide glucose) is used, distributed and stored by body tissues and is metabolized to carbon dioxide and water with the release of energy.|
|Heparin||Ergotamine||Reverses hypercoagulable state by interacting with antithrombin III. Used in combination with vasodilator phentolamine or nitroprusside to prevent local thrombosis and ischemia.|
|Hydroxocobalamin||Cyanide||Forms cyanocobalamin, a non-toxic metabolite that is easily excreted through the kidneys.|
|Methotrexate||Protects the healthy cells from the effects of methotrexate while allowing methotrexate to enter and kill cancer cells.|
|Magnesium sulfate||calcium gluconate|
|mesna||Cyclophosphamide||A “chemoprotectant” drug that reduces the undesired effects of certain chemotherapy drugs.|
|Methylene blue||Chemical producing severe methemoglobinemia. Ifosamide-induced encephalopathy.||Reduces methemoglobin to hemoglobin.|
|nalmefene or naloxone||Opioid analgesics||Prevents or reverses the effects of opioids including respiratory depression, sedation and hypotension.|
|naloxone (Narcan)||Narcotics||Naloxone is believed to antagonize opioid effects by competing for the µ, κ and σ opiate receptor sites in the CNS, with the greatest affinity for the µ receptor.|
|Neostigmine||Anticholinergics||Anticholinesterase which causes accumulation of acetylcholine at cholinergic receptor sites.|
|Nitrite, sodium and glycerytrinitrate||Cyanide||Oxidizes hemoglobin to methemoglobin which binds the free cyanide and can enhance endothelial cyanide detoxification by producing vasodilation.|
|Penicillamine||Copper, gold, lead, mercury, zinc, arsenic||Chelation of metal ions.|
|phentolamine (Regitine)||Dopamine||Regitine produces an alpha-adrenergic block of relatively short duration. It also has direct, but less marked, positive inotropic and chronotropic effects on cardiac muscle and vasodilator effects on vascular smooth muscle.|
|phyostigmine or NaHCO3||Tricyclic antidepressants||A reversible anticholinesterase which effectively increases the concentration of acetylcholine at the sites of cholinergic transmission.|
|Phytomenadione (Vitamin K.)||Coumadin/Warfarin||Bypasses inhibition of Vitamin K epoxide reductase enzyme.|
|protamine sulfate||Heparin||Protamine that is strongly basic combines with acidic heparin forming a stable complex and neutralizes the anticoagulant activity of both drugs.|
|Pyridoxine||Isoniazid, theophylline, monomethyl hydrazine. Adjunctive therapy in ethylene glycol poisoning.||Reverses acute pyridoxine deficiency by promoting GABA synthesis. Promotes the conversion of toxic metabolite glycolic acid to glycine.|
|Snake anti-venin||Cobra bite||Neutralizes venom by binding with circulating venom components and with locally deposited venom by accumulating at the bite site.|
|Sodium Bicarbonate||Iron||Prevents convertion of ferrous to ferric.|
|Cardiotoxic drug affecting fast sodium channel (TCA, cocaine)||Decreases affinity of cardiotoxic drugs to the fast sodium channel.|
|Weak acids||Promotes ionization of weak acids.|
|Chlorine gas inhalational poisoning||Neutralization of hydrochloric acid formed when chlorine gas reacts with water in the airways.|
|Sodium thiosulphate||Cyanide||Replenishes depleted thiosulphate stores by acting as sulfur donor necessary for the conversion of CN-O to thiocyanate through the action of sulfur transferase enzyme rhodanese.|
|Thiamine||Alcohol, Wernicke-Korsakoff Syndrome||Reverses acute thiamine deficiency|
|Adjunctive in ethylene glycol||Enhances detoxification of glyoxylic acid.|
|Vitamin C||Chemicals causing methemoglobinemia in patients with G6PD deficiency||Reduces methemoglobin to hemoglobin.|
Our recommended nursing pharmacology resources and books:
Pharm Phlash! Pharmacology Flash Cards #1 BEST SELLER!
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Focus on Pharmacology (8th Edition)
Focus on Nursing Pharmacology makes challenging concepts more approachable. Engaging learning features cultivate your clinical application, critical thinking and patient education capabilities. This updated 8th edition builds on your knowledge of physiology, chemistry and nursing fundamentals to help you conceptualize need-to-know information about each group of drugs.
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Lehne’s Pharmacology for Nursing Care (11th Edition)
The Eleventh Edition of Lehne’s Pharmacology for Nursing Care provides a thorough understanding of key drugs and their implications for nursing care. This text, written by renowned nursing educators, helps you comprehend and apply pharmacology principles. A clear and engaging writing style simplifies complex concepts, making even the most challenging pharmacology content enjoyable. We recommend this book if you want a comprehensive nursing pharmacology guide.
Nursing Drug Handbook
Nursing2023 Drug Handbook delivers evidence-based, nursing-focused drug monographs for nearly 3700 generic, brand-name, and combination drugs. With a tabbed, alphabetical organization and a “New Drugs” section, NDH2023 makes it easy to check drug facts on the spot.
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The 10th edition of Pharmacology and the Nursing Process offers practical, user-friendly pharmacology information. The photo atlas contains over 100 unique illustrations and photographs depicting drug administration techniques. Updated drug content reflects the most recent FDA drug approvals, withdrawals, and therapeutic uses.
Mosby’s Pharmacology Memory NoteCards: Visual, Mnemonic, and Memory Aids for Nurses
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Here are other nursing pharmacology study guides:
- Nursing Pharmacology – Study Guide for Nurses
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- Drug Dosage Calculations NCLEX Practice Questions (100+ Items)
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Drug Guides NEW!
Individual drug guides and nursing considerations for the most common medications used in nursing pharmacology:
- Acetaminophen (Tylenol)
- Atorvastatin (Lipitor)
- Enoxaparin (Lovenox)
- Furosemide (Lasix)
- Hydromorphone (Dilaudid)
Gastrointestinal System Drugs
Respiratory System Drugs
- Bronchodilators and Antiasthmatics
- Expectorants and Mucolytics
- Inhaled Steroids
- Lung Surfactants
Endocrine System Drugs
- Adrenocortical Agents
- Antidiabetic Agents
- Glucose-Elevating Agents
- Hypothalamic Agents
- Parathyroid Agents: Bisphosphonates, Calcitonins
- Pituitary Drugs
- Thyroid Agents
Autonomic Nervous System Drugs
- Adrenergic Agonists (Sympathomimetics)
- Adrenergic Antagonists (Sympatholytics)
- Anticholinergics (Parasympatholytics)
- Cholinergic Agonists (Parasympathomimetics)
Immune System Drugs
- Anti-Infective Drugs
- Antineoplastic Agents
- Antiprotozoal Drugs
- Antiviral Drugs
Reproductive System Drugs
Nervous System Drugs
- Antiparkinsonism Drugs
- Antiseizure Drugs
- Anxiolytics and Hypnotic Drugs
- General and Local Anesthetics
- Muscle Relaxants
- Narcotics, Narcotic Agonists, and Antimigraine Agents
- Neuromuscular Junction Blocking Agents
- Psychotherapeutic Drugs
Cardiovascular System Drugs