TABLE 2

Potentially Useful Rescue, Reversal, and/or Antidotal Agents

Agent/ConditionRescue, Reversal, and/or Antidote
Chemical intoxications
    Alcohol, toxic (eg, methanol)Ethanol, thiamine, fomepizole (4 methyl-1H-pyrazole)
    IronDeferoxamine
    Carbon monoxideOxygen
    CyanideHydroxocobalamin (Cyanokit; Dey, LP, Napa, CA) is preferred antidote; cyanide kit (amyl nitrate, sodium nitrate, sodium thiosulfate) may be used if hydroxocobalamin unavailable
    LeadDimercaprol (British anti-Lewisite [BAL]); edetate calcium disodium (Ca- EDTA); DMSA (succimer [Chemet])
Drug intoxications
    AcetaminophenN-acetylcysteine
    BenzodiazepinesFlumazenil
    β-adrenergic blockersGlucagon
    DigoxinDigoxin immune Fab (Digibind; GlaxoSmithKline, Research Triangle Park, NC)
    HeparinProtamine sulfate
    IsoniazidPyridoxine
    OpiatesNaloxone, nalmefene
Envenomations
    Snake bitesSnake-specific antivenoms (eg, CroFab [Protherics, Yorkshire, United Kingdom] for Crotalidae [rattlesnakes]; coral snake antivenom, etc)
    Black widow spider bitesLatrodectus antivenom
Metabolic crises
    MethemoglobinemiaMethylene blue
    HyperkalemiaBicarbonate, glucose and insulin, calcium, sodium polystyrene resin (Kayexalate)
Miscellaneous
    Nondepolarizing muscle relaxantsNeostigmine, pyridostigmine, edrophonium
    Cholinergics (organophosphates, carbamates)Atropine, pralidoxime
Radionuclides
    IodinePotassium iodide
    PlutoniumPentetate calcium disodium (Ca-DTPA) within 24 h followed by pentetate zinc trisodium (Zn-DTPA)
    AmericiumZn-DTPA or Ca-DTPA
    UraniumSodium bicarbonate and tubular diuretics
    CesiumPrussian blue
    TritiumWater
    PhosphorusIndividualize treatment; consult Poison Control Center
  • Consultation with a toxicologist or the Poison Control Center (national telephone number: 800-222-1222) strongly advised if considering antidote administration.