Kerala State Drug Formulary.pdf

General Topics
should be monitored. Behavioral abnormalities including combativeness and
agitation are better controlled by physical restraints rather than chemical
restraints .Diazepam enables rapid control of unmanageable patients while
haloperidol is very effective for long term control.
4. Antidotes ;
Next to the general emergency measures, antidotes form the
mainstay of successful management of poisonings as early as possible and
during the course of treatment blood and urine samples should be sent for
drug level monitoring.
DEFINITIVE CARE
POISON ANITDOTE ADULT DOSAGE COMMENT
1. Paracetamol N-acetylcysteine Initial dose140mg/ kg
orally,
then70mg/kg4h
2. Atropine Physostigmine Initial dose0.5·2mgi
IV
3. Carbonmonoxide Oxygen 100%by face mask or
Hyperbaric oxygen if
available.
4. Cyanide Amylnitrite, sodium
nitrite
so dium thiosulphate
Amylnitrite inhalation
every2-
3min,then10mL
of 3%sodium nitrite
I.V over5min then
50mL25%
Sod.thiosolphate
over 10min
5. Iron salts Desferrroxamine Hypotensive patients
– 10mg/kg/h for 4
hours IV, 5mg/kg/h
for 8 hours then 2-
5mg/kg/h
Normotensive
patients 40mg/kg IM
6. Lead salt
e.g. Lead acetate
7. Mercury, Arsenic,
Gold
Calcium di sodium
edetate
BAL (Dimercaprol)
200mg/ml in amp of
5ml to be diluted in
5% glucose infused IV.
Total dose of 50-
75mg/kg/day in 2
divided doses up to 5
days
5mg/kg deep intra
muscular
Most effective if
given within16h
Can produce
convulsions
Early treatment is
successful
This helps to
remove the
poison load but
action is slow.
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