ANTIDOTE CHART - California Poison Control System

Romazicon®Fomepizole (4-MP)/Antizol®GlucagonHydroxycobalamin/Cyanokit®Preferred antidote forEthylene glycol orMethanol poisoningBeta-blocker/CalciumChannel blocker poisoningCyanide poisoningavoid abrupt awakening/delirium. Do not use inpatients on chronicbenzodiazepine therapy aswithdrawal will occur.Manufacturers will replaceexpired stocksAnticipate nausea andvomitingSafer to use than thenitrites found in theconventional cyanideantidote kit.mL vials24 hours: 12 mg or 12 x 1mg/10 mL vials8 hours: 1.5 g or 1 x 1.5mL(1g/mL) vials24 hours: 6.0 g or 4 x 1.5 mL(1g/mL) vials8 hours: 90 mg or 90 x 1 mgkits24 hours: 250 mg or 250 x 1 mgkits8 hours: 10 g or 2 kits24 hours: 10 g or 2 kitsMethylene Blue Methemoglobinemia 8 hours: 400 mg or 4 x 10mL(10 mg/mL) amps24 hours: 600 mg or 6 x 10mL(10mg/mL) ampsN-Acetylcysteine(NAC)/ Mucomyst®or generic (oralpreparation)N-Acetylcysteine(NAC)/ Acetadote®(IVpreparation)Naloxone/Narcan®Octreotide acetate/Sandostati n®D-Penicilliamine/Cupramine®Physostigmine/Antilirium®Pralidoxime (2-PAM)/Protopam®Prussian Blue/Radiogardase®Pyridoxine (VitaminB 6 )Vitamin K 1(Phytonadione)/Mephyton® orAquaMephyton®Acetaminophen poisoningAcetaminophen poisoningOpiate and OpioidoverdoseOral Sulfonylurea poisoningHeavy Metal poisoningAnticholinergic poisoningespecially antimuscarinicagitated deliriumCholinesterase inhibitorpoisoning(Organophosphate or“nerve gas” agent)poisoningDirty bomb agents;radioactive cesium,thallium and nonradioactivethalliumIsoniazid (INH) poisoningWarfarin, warfarin-basedanticoagulants and superwarfarinbased rodenticidepoisoningUse orally. Dilute at leastby a 3:1 ratio.Loading dose should beinfused slowly over 45-60minutes. Generic N-acetylcysteine can be usedIV if Acetadote® is notavailable (consult withpoison center and give viamicropore filter).Use small initial dose toavoid abrupt awakening/delirium.Avoid long-acting depotproducts.Possible cross-sensitivityin patients allergic topenicillinAdminister at low dose(0.5 mg) and slowly(over2-5 mins)to avoid severeside effects includingbradycardia, asystole andseizures(contraindicatedin TCA poisoning)Also stocked in theStrategic NationalStockpile but will needsupplies for first 48 hours.Coordinate with localHomeland Security officeStocked in the StrategicNational Stockpile but willneed supplies for first 48hours. Coordinate withlocal Homeland SecurityofficeLarge amounts needed forpoisoning: 5 grams is theminimum antidotal doseused in an ingestion of anunknown amount. Note:the 100 mg in 1 ml vialscontain the preservativechlorobutanol. A 5 gramdose requires 50 vials andwill deliver a toxic dose ofthe preservativeIf patient activelybleeding, use fresh frozenplasma or Factor VIIconcentrate8 hours: 28 g or 5 x 30mL (20%)vials24 hours: 56 g or 10 x 30 mL(20%) vials8 hours: 24 g or 1 carton of 4 x30mL (20%) vials24 hours: 30 g or 5 x 30 mL(20%) vials8 hours: 20 mg or 50 x0.4mg/2mL amps or 2 x10mg/10mL vials24 hours: 40 mg or 4 x10mg/mL vials8 hours: 200 mcg or 2 x 1mL(0.1mg/mL) amps24 hours: 1000 mcg or1 x 5ml (0.2mg/mL) MDV8 hours: 500 mg or 2 x 250mgcapsules24 hours: 1500 mg or 6 250 mgtitratable tablets8 hours: 4 mg or 2 x 2mL(1mg/mL) amps24 hours: 20 mg or 10 x 2 mL(1 mg/mL) amps8 hours: 7 g or 7 x 1gm (20mL)vials24 hours: 18 g or 18 x 1gm(20mL) vialsMinimum order is 25 bottles(30 capsules each)8 hours: 9 g or 3 vials(100mg/mL, 30 mL each) or theequivalent (Use preservativefree product.)24 hours: 24 g or 8 vials(100mg/mL, 30 mL each) or theequivalent8 hours: 50 mg or 10 x 5mgtabs or 5 x 10mg/mL amps24 hours: 100 mg or 20 x 5 mgtabs or 10 x 10mg/mL ampsExpert advice regarding use of antidotes is available 24 hours a day/7 days a week from the California PoisonControl System**. Call us at: