Famous Antidotes & Therapeutic Levels
Flashcards to memorize antidotes
Vitamin K
Protamine Sulfate
Digibind or Digifab
acetylcysteine (Mucomyst)
Flumazenil (Romazicon)
Naloxone (Narcan)
Glucagon
Glucagon
That Glucagon can save lives!
Physostigmine
Calcium Gluconate
Deferoxamine
Succimer or Calcium Disodium Edetate (Chelating Agents). Chelating agents are compounds that react with metal ions to form water-soluble complexes. So calcium Disodium Edate binds with lead to get rid of it.Â
Chlordiazepoxide (Librium)
Glucagon or Dextrose.
Deferoxamine
Sodium Bicarbonate
Hydroxocobalamin
Cogentin (Benztropine) or Benadryl
Atropine
- 0.5 – 2.0 ng/mL
- Toxic if > 2
- #1 sign of toxicity = diarrhea
- Other symptoms: #1 Diarrhea, n/v, visual disturbances (yellow halos),  confusion, ataxia, and palpitations
- Hypokalemia potentiates digoxin Toxicity.
- Antidote = Digibind or Digifab
- 0.8-1.2 mEq/L
- Toxic > 1.5
- Toxicity potentiated by HYPONATREMIA
- Toxicity: Early Tremors and N/V and diarrhea. Also, Nystagmus, slurred speech, and seizures
- 5 – 10 mg/dL
- High levels: Ototoxic (Tinnitus/hearing loss) and nephrotoxicity
- 10 – 20 mcg/mL
- Toxicity: Ataxia, confusion, nystagmus, hypotension, CNS depression, somnolence, sedation, gingival hyperplasia & Stevens-Johnson syndrome (SJS)= painful rash/blisters.
- Mix the IV form only with normal saline. Do not mix with dextrose 5%. It will precipitate. Administer at a rate of 50mg/min. If given too fast it can cause cardiac arrhythmias.Â
- It should not be given in a small vein because it is very irritating. Â
- The oral form is better if taken on an empty stomach to maximize absorption. But if GI upset occurs, it can be taken with food.Â
- If the client is on tube feeds give on hour before tube feedings or 2 hours after tube feedings.Â
- 10 – 20 mcg/mL
- Toxicity: Tachycardia, nausea, vomiting, and hyperglycemia
- 10 – 30 mcg/mL . Some sources use 10-40
- Toxicity: Hypotension and CNS depression.
- 100- 300 mcg/mL
- Toxicity: Ototoxic, hyperventilation (respiratory alkalosis), nausea, vomiting, and metabolic acidosis
- Normal level is 4-7 mg/dL on a drip such as when treating pre-eclampsia (prevents seizures by relaxing the central nervous system).
- Toxicity: hypotension, CNS depression, depressed DTRs, decreased respiratory rate. Everything slows down with Hypermagnesemia.
- 10 – 20 mcg/mL
- Toxicity: n/v, diarrhea, all the way to liver damage.
- Peak 20 – 40 mcg/mL
- Trough 5 -15 mcg/mL
- Nephrotoxicity: Watch urine output, potassium, BUN, and creatinine.
- Red man syndrome can happen when given too fast. It typically consists of pruritus and erythematous rash that involves the face, neck, and upper torso.
- Ok, this guy is red because he is angry. But it will help you remember red man syndrome.
- 50 – 100 mcg/mL
- Toxicity: CNS depression, coma, & respiratory depression
- It may cause weight gain