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Antidote chart for_cpcs_2008
1. California Poison Control System
ANTIDOTE CHART
(Suggested Stocking Level is based on dose to treat a 70 kg patient for 24 hours)*
Updated: 3-11-2008
Suggested
Generic/ Name Brand Toxin Notes Stocking
Level
May require large amounts in
Organophosphate/Carbamate
severe cholinesterase inhibitor
insecticide poisoning and
poisoning. Also stocked in the 1000 mg total (in vials)
other cholinesterase
Atropine Strategic National Stockpile but Use preservative free
inhibitors (eg, warfare
will need supplies for first 48 product
agents); bradycardia induced
hours. Coordinate with local
by a variety of toxins
Homeland Security office.
Antivenom, Crotalidae Polyvalent
® Rattlesnake envenomation 24 vials
Immune-FAB(ovine)/ Cro-Fab
Antivenom, Black Widow Spider/
Black Widow Spider
Antivenom (Latrodectus 1 x 6000u vial
® envenomation
Mactans)
BAL(Dimercaprol)/ BAL in oil 6 x 3 mL (10% in oil)
Heavy Metal poisoning
10%® amps
Calcium channel blocker Can cause tissue necrosis if
Calcium Chloride injection poisoning; hypocalcemia extravasation occurs – use large 20 x 10mL (10%) vials
induced by various agents vein for infusion.
Calcium Gluconate Powder Hydrofluoric Acid For manufacture of topical gel 1 x 100gm powder bottle
Hydrofluoric Acid skin
exposure or poisoning;
Calcium Gluconate injection 20 x 10mL (10%) vials
hypocalcemia induced by
various agents
Calcium Gluconate gel/Calgonate Hydrofluoric Acid dermal
® For topical burns 6 x 25 gm tubes
2.5% gel burns
® Hyperammonemia from
Carnitine (L-Carnitine)/ Carnitor 7 x 1gm vials
valproic acid toxicity
Thiosulfate component can be 2 kits (or stock the
Cyanide Antidote Kit/ Taylor
Cyanide poisoning used separately. See also Cyanokit® - see
Cyanide Antidote Kit®
Hydroxocobalamin (Cyanokit®). Hydroxocobalamin)
Deferoxamine/ Desferal® Iron poisoning IM administration is discouraged. 12 x 500mg vials
Digoxin poisoning; Other Consult with poison center
Digoxin Immune FAB (ovine)/ 15 vials of either
cardiac glycosides (eg, regarding dosing, especially for
Digibind® or DigiFab® product
oleander, foxglove) cardiac glycosides than digoxin.
DMSA (Succimer)/ Chemet® Heavy metal poisoning 1 x 100 capsule bottle
Also stocked in the Strategic
DTPA-Calcium
Dirty bomb agents: National Stockpile but will need
(Diethylenetriamine pentaacetate)/
Radioactive plutonium, supplies for first 48 hours. 1 x 1gm vial
Pentetate Calcium Trisodium
americium and curium Coordinate with local Homeland
injection)
Security office.
Also stocked in the Strategic
DTPA-Zinc (Diethylenetriamine Dirty bomb agents: National Stockpile but will need
pentaacetate)/ Pentetate Zinc Radioactive plutonium, supplies for first 48 hours. 1 x 1gm vial
Trisodium injection) americium and curium Coordinate with local Homeland
Security office.
EDTA-Calcium/ Versenate® Heavy metal poisoning 18x 1000mg/5mL amps
Note: Ethanol more difficult to
Ethylene glycol or Methanol Product no longer
Ethanol IV 10% obtain, dose and monitor than
poisoning manufactured
fomepizole.
2. Use small initial dose to avoid
Flumazenil/ Romazicon® Benzodiazepine poisoning 5 x 0.5 mg/5mL vials
abrupt awakening/ delirium.
Preferred antidote for
Manufacturer will replace expired 4 x 1.5mL (1gm/mL)
Fomepizole (4-MP)/ Antizol® Ethylene glycol or Methanol
stocks. vials
poisoning
Beta blocker/ Calcium
Glucagon Anticipate nausea and vomiting. 10 x 1 mg vials
channel blocker poisoning
Newer cyanide antidote, can be
® 3 x 5gm kits (or stock
Hydroxycobalamin/ Cyanokit Cyanide poisoning used instead of the conventional
the Taylor cyanide kit)
cyanide antidote kit from Taylor.
5 x 10mL (1%) amps
Methylene Blue Methemoglobinemia
(10mg/mL)
N-Acetylcysteine (NAC) Acetaminophen poisoning Use orally. Dilute at least by a 3:1
7 x 30mL (20%) vials
Mucomyst® or generic (oral preparation) ratio.
Loading dose should be infused
slowly over 45-60 minutes.
N-Acetylcysteine (NAC) Acetaminophen poisoning Generic N-acetylcysteine can be 1 carton of 4 x 30mL
®
Acetadote (IV preparation) used if Acetadote® is not available (20%) vials
(consult with poison center and
give via micropore filter).
Use small initial dose to avoid 20 x 0.4mg/2mL amps or
Naloxone/ Narcan® Opioid overdose
abrupt awakening/ delirium. 10 x 10mg/10mL vials
2 x 1mL (0.1mg/mL)
Octreotide acetate/ Sandostatin® Oral sulfonylurea poisoning Avoid long-acting depot products. amps
1 x 5ml 0.2mg/1ml MDV
Anticholinergic poisoning, Administer slowly: May cause
®
Physostigmine/ Antilirium especially antimuscarinic severe side effects including 10 x 2mL (1mg/mL) vials
delirium. bradycardia, asystole and seizures
Also stocked in the Strategic
Cholinesterase Inhibitor National Stockpile but will need
Pralidoxime(2-PAM)/ Protopam® poisoning (organophosphate supplies for first 48 hours. 12 x 1gm (20mL) vials
or “nerve gas”) Coordinate with local Homeland
Security office.
Also stocked in the Strategic
Dirty bomb agents:
National Stockpile but will need
® radioactive cesium and 2 packs of thirty 500 mg
Prussian Blue/ Radiogardase supplies for first 48 hours.
thallium and non-radioactive capsules
Coordinate with local Homeland
thallium
Security office.
Large amounts needed for
poisoning: 5 grams is the
minimum antidotal dose used in
50 x 1mL (100 mg/mL) or
an ingestion of an unknown
the equivalent (Use
Pyridoxine (Vitamin B6) Isoniazid (INH) poisoning amount. Note: the 100 mg in 1 ml
preservative free
vials contain the preservative
product.)
chlorobutanol. A 5 gram dose
requires 50 vials and will deliver a
toxic dose of the preservative.
Warfarin, warfarin-based
Vitamin K1(Phytonadione)/ If patient is actively bleeding use
anticoagulants and super- 20 x 5mg tabs
® ®
fresh frozen plasma or Factor VII
Mephyton or AquaMephyton warfarin based rodenticide 10 x 10mg/mL amps
concentrate.
poisoning
Expert advice regarding use of antidotes is available 24 hours a day, 7 days a week
from the California Poison Control System. Call us at
1-800-222-1222
*Adapted From Olson, KR (Ed): Poisoning & Drug Overdose. 5th Edition. McGraw-Hill. New York. 2007
Note: List is not all-inclusive but reflects agents used more exclusively as antidotes
or antidotal agents used infrequently.
Updated: 3-11-2008