Atropinics & Anticholinergics
(Atropine, Tricyclic, Antidepressants, Phenothiazines, Antihistamines)
- VS: fever, tachycardia, hypertension, cardiac arrhythmias
- CNS: delirium, psychosis, coma, convulsions
- Eye: mydriasis, dilated pupils
Amphetamines & Sympathomimetics
(OTC cold preps & diet pills)
- VS: fever, tachycardia, hypertension
- CNS: hyperactive, delirious,tremulous, myoclonus, psychosis, convulsions
- Eye: mydriasis, dilated pupils
- Skin: flushing, severe sweating
Barbiturates & Sedatives / Hypnotics
- VS: hypothermia, hypotension, bradypnea
- CNS: confusion, coma, ataxia
- Eye: nystagmus, miosis, mydriasis
- Skin: vesicles, bullae
Opiates
- VS: bradycardia, bradypnea, hypotension, hypothermia
- CNS: euphoria to coma, hyporeflexia
- Eye: pinpoint pupils
Organophosphate / Cholinergic
- VS: bradycardia or tachycardia, tachypnea
- CNS: confusion, drowsiness, coma, convulsions, muscle, fasciculations, weakness, paralysis
- Eye: pinpoint pupils, blurry vision, lacrimation
- Skin: sweating
- Odor: garlic
- Misc: salivation, bronchorrhea, bronchospasm, pulmonary edema, diarrhea, increased urine.
Phenothiazines
- VS: postural hypotension, hypothermia, tachycardia, tachypnea
- CNS: lethargy, coma, tremor, convulsions, ataxia, torticollis, back aching, oculogyric crisis, trismus, tongue protrusion
- Eye: Miosis
Salicylates
- VS: fever, tachypnea
- CNS: lethargy, coma
- Odor: oil of wintergreen with methyl salicylate
- Misc: vomiting, acidosis
Theophylline
- VS: tachycardia, arrhythmias
- CNS: headaches, restlessness, muscle twitching, seizure
- Misc: vomiting, hematemesis
Antidotes
acetaminophen
anesthetic/vasoconstrictor combos, local dental
anticholinergics
arsenic
- [dimercaprol OR penicillamine]
benzodiazepines
beta blockers
calcium channel blockers
carbamates
- [atropine OR pralidoxime (2-PAM)]
cholinergics
- [atropine OR pralidoxime (2-PAM)]
cholinesterase inhibitors
- [atropine OR pralidoxime (2-PAM)]
-
- Info: may use glycopyrrolate or hyoscyamine to prevent muscarinic effects of cholinesterase inhibitors
copper
- [penicillamine OR trientine]
cyanide
- [hydroxocobalamin OR sodium nitrite AND sodium thiosulfate]
-
- Info: may give amyl nitrite before sodium nitrite
digitalis/digoxin
-
- Info: may add colestipol if w/in 1-3h after last oral digoxin ingestion
ethylene glycol
folate antagonists
gold
heavy metals
- [dimercaprol OR penicillamine]
heparin
hypoglycemics
iron
- [deferoxamine OR deferasirox]
lead
- [calcium EDTA OR dimercaprol OR penicillamine OR succimer]
mercury
- [dimercaprol OR penicillamine]
methanol
methemoglobinemia
methotrexate
- [leucovorin OR levoleucovorin]
neuromuscular blockers, non-depolarizing
- [edrophonium OR neostigmine OR physostigmine]
-
- Info: may use glycopyrrolate or hyoscyamine
-
- to prevent muscarinic effects of cholinesterase inhibitors
opioids
organophosphates
- [atropine OR pralidoxime (2-PAM)]
scorpion sting
- [Centruroides immune Fab]
snake bite
- [antivenin (Micrurus fulvius)]
-
- Info: for North American Coral snake bite
- [Crotalidae polyvalent immune Fab]
-
- Info: for North American Crotalid snake (rattlesnake) bite
spider bite
- [antivenin (Latrodectus mactans)]
-
- Info: for black widow spider bite
warfarin