10.2 Toxicology & Antidotes
Toxicology addresses poisoning, overdose management, and antidote therapy. Recognizing toxidromes and knowing specific antidotes can be life-saving.
Common Antidotes
| Toxin | Antidote | Mechanism |
|---|---|---|
| Acetaminophen | N-acetylcysteine | Replenishes glutathione; prevents NAPQI toxicity |
| Opioids | Naloxone | ฮผ-opioid receptor antagonist |
| Benzodiazepines | Flumazenil | GABA-A receptor antagonist (caution: seizures) |
| Warfarin | Vitamin K, FFP, PCC | Replenish clotting factors |
| Heparin | Protamine sulfate | Binds and neutralizes heparin |
| Anticholinergics | Physostigmine | Acetylcholinesterase inhibitor (crosses BBB) |
| Organophosphates | Atropine + pralidoxime | Blocks muscarinic effects; reactivates AChE |
| ฮฒ-blockers, CCBs | Glucagon, calcium, insulin | Inotropic support, overcome blockade |
| Digoxin | Digoxin-specific Fab | Binds and inactivates digoxin |
| Iron | Deferoxamine | Chelates free iron |
| Lead | EDTA, succimer, dimercaprol | Chelation therapy |
| Cyanide | Hydroxycobalamin, sodium thiosulfate | Binds cyanide; provides sulfur for detox |
| Methanol, ethylene glycol | Fomepizole, ethanol | Inhibit alcohol dehydrogenase |