California Poison Control System ANTIDOTE CHART (Suggested Stocking Level is based on dose to treat a 70 kg patient for 24 hours)* 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 agents); bradycardia induced hours. Coordinate with local by a variety of toxins Homeland Security office. Antivenom, Crotalidae Polyvalent 24 vials, may need up to Rattlesnake envenomation Immune-FAB(ovine)/ Cro-Fab® 35 vials for treatment 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 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® Hyperammonemia from Carnitine (L-Carnitine)/ Carnitor® 7 x 1gm vials valproic acid toxicity 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® oleander, foxglove) cardiac glycosides than digoxin. DMSA (Succimer)/ Chemet® Heavy metal poisoning 1 x 100 capsule bottle DTPA-Calcium Stocked in the Strategic National Dirty bomb agents: (Diethylenetriamine pentaacetate)/ Stockpile but will need supplies Radioactive plutonium, 1 x 1gm vial Pentetate Calcium Trisodium for first 48 hours. Coordinate with americium and curium injection) local Homeland Security office. Stocked in the Strategic National DTPA-Zinc (Diethylenetriamine Dirty bomb agents: Stockpile but will need supplies pentaacetate)/ Pentetate Zinc Radioactive plutonium, 1 x 1gm vial for first 48 hours. Coordinate with Trisodium injection) americium and curium local Homeland Security office. EDTA-Calcium/ Versenate® Heavy metal poisoning 18x 1000mg/5mL amps Fomepizole easier to dose and Note: IV 10% ethanol Ethanol IV 10% Ethylene glycol or Methanol monitor than ethanol. Oral ethanol product no longer poisoning can be used in an emergency manufactured situation. Fomepizole easier to dose and Ethylene glycol or Methanol monitor than ethanol. Oral ethanol Ethanol (oral) / Vodka One 750ml bottle poisoning can be used in an emergency situation. 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 poisoning Beta blocker/ Calcium Glucagon Anticipate nausea and vomiting. 10 x 1 mg vials channel blocker poisoning Safer to use than the conventional 3 x 5gm kits (or stock Hydroxycobalamin/ Cyanokit® Cyanide poisoning cyanide antidote kit from Taylor. the Taylor cyanide kit) 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) 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 Possible cross-sensitivity in 1500mg, 1 bottle 250mg D-Penicillamine/ Cupramine® Heavy metal poisoning patients allergic to penicillin capsules 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. Dirty bomb agents: Stocked in the Strategic National radioactive cesium and Stockpile but will need supplies 2 packs of thirty 500 mg Prussian Blue/ Radiogardase® thallium and non-radioactive for first 48 hours. Coordinate with capsules thallium local Homeland 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. Kit contains 2-10ml amps of sodium nitrite, 2-50ml vials of Taylor Cyanide Antidote Kit sodium thiosulfate, 12 amyl nitrite inhalant ampules Warfarin, warfarin-based Vitamin K If patient is actively bleeding use 1(Phytonadione)/ 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: 6-26-2009
Association : « POURTANT LA VIE » Accompagnement et soins pal iatifs 07.03.06 SOINS DE BOUCHE DANIELLE BARTOLONI – IDE - Équipe mobile de soins palliatifs PHYSIOPATHOLOGIE DES ALTERATIONS BUCCALES : --------------------------------------------------------------------------------------------------------------- CANDIDOSES NUTRITION COMMUNICATION ou VIRALES e
RESULTS: The patient’s hormone levels remained menopausal until August2011 when a peak estradiol level of 1166 pmol/L and FSH of 10.2 IU/L and LHmorphology alone drives the current practice to transfer multiple embryosof 15.3 IU/ L was recorded indicating ovarian function. A decision was thento patients to maximize the chances of pregnancy. Unfortunately, thismade to proceed with an IVF cyc