Oral ethanol-containing beverage (eg, whiskey, vodka) can be used in an emergency situation.Ģ4 hours: 2450 mL of 80 proof (40%) liquor (10% solution can be prepared using 98% ethanol product) Note: fomepizole is the preferred antidote due to easier dosing, monitoring and safety.Ĩ hours: 22 x (5 mL) vials or ampules of 98% solution for injection Lead poisoning also zinc, manganese, and certain radioisotopes The Radiation Emergency Assistance Center/Training Site (REAC/TS) can be contacted for information on use of antidote. Special access - Strategic National Stockpile. Business hours: 1-86 After hours: 1-86.ĭTPA-Zinc (Diethylenetriamine pentaacetate)/ (Pentetate Zinc Trisodium injection) Stocked in the Strategic National Stockpile: supplies for first 48 hours coordinated by state department of health and emergency response system. Only available through government sources. Heavy metal poisoning (lead, mercury, arsenic)ĭTPA-Calcium (Diethylenetriamine pentaacetate)/ (Pentetate Calcium Trisodium injection)ĭirty bomb agents: radioactive plutonium, americium and curium Preferred antidote for cyanide poisoning due to better safety and easier use.Īnticholinergic side effects and only PO administrationĭigoxin poisoning other cardiac glycosides (eg, oleander, foxglove)Ĭonsult with poison center regarding dosing, especially for cardiac glycosides other than digoxin Thiosulfate is synergistic with sodium nitrite, and the two drugs should be used together to treat cyanide poisoning whenever possible.Ģ x 50 mL (25%) vials 6 vials for major medical centers If used alone for cyanide toxicity, may have a slow onset of action. Risk of methemoglobinemia and hypotension with use.Ģ x 10 mL (3%) vials 6 vials for major medical centers Hyperammonemia &/or hepatotoxicity from valproic acid toxicityĬyanide Antidote Kit (Nithiodote by Hope Pharmaceuticals)Ĭonventional cyanide antidote: contains 1-10 mL (300 mg) vial of sodium nitrite, 1-50 mL (12.5 g) vial of sodium thiosulfate (amyl nitrite inhalant ampules not included)Ģ kits for small hospitals, 6 kits for major medical centers or stock separate supplies of sodium thiosulfate and sodium nitrite vials OR stock the Cyanokit® (hydroxocobalamin) antidote kit (see below)
POISON ANTIDOTE KIT SKIN
Hydrofluoric acid skin exposure or poisoning hypocalcemia induced by various agentsĨ and 24 hours: 30 g or 30 vials (10%, 10 mL)Ĭalcium Gluconate gel/ Calgonate 2.5% gel® Special Access CDC 1-770-488- 7100 California call: 1-91 LA call: 1-21Ĭalcium channel blocker poisoning hypocalcemia induced by various agentsĬan cause tissue necrosis if extravasation occurs – use large vein for infusion OR use calcium gluconate injection (see below)Ĩ and 24 hours: 10 g or 10 vials (10%, 10 mL) Only available through the state health department (CA) or CDC
IV bolus dosing for reversal of sodium channel blocker toxicity monitor alkalemiaĨ hours: 63 g (750 mEq) or 750 mL of 8.4% solutionĢ4 hours: 84 g (1000 mEq) or 1 L of 8.4% solutionīotulinum antitoxin / H- BAT- heptavalentĬontact local or state health department for reporting and to facilitate access to the antitoxin. Sodium channel blocker toxicity & urinary alkalinization Heavy metal poisoning (Arsenic, mercury, lead and gold)Ĩ hours: 800 mg or 3 amps (100 mg/mL, 3 mL each)Ģ4 hours: 2400 mg or 8 amps (100 mg/mL, 3 mL each)
Special Access: (Merck, 1-800-672- 6372) Merck Order Management Center, 1-80, will drop ship up to 2 vials. Also stocked in the Strategic National Stockpile: for mass casualties, the SNS may provide supplies for first 48 hours (coordinated by state department of health and emergency response system).Ĩ Hours: 100 mg or 13 vials (0.4 mg/mL, 20 mL each)Ģ4 hours: 200 mg or 26 vials (0.4 mg/mL, 20 mL each)Īntivenom, Crotalidae Polyvalent Immune- FAB(ovine)/ Cro-Fab®Įither antivenom product equally efficaciousĪntivenom, Crotalidae Immune- FAB 2(equine)/ Anavip®Īntivenom, Black Widow Spider/ Antivenom (Latrodectus Mactans)®Įquine base risk of allergic hypersensitivity May require large amounts in severe cholinesterase inhibitor poisoning. Organophosphate/ carbamate insecticide poisoning and other cholinesterase inhibitors (eg, warfare agents) bradycardia induced by a variety of toxins Medical centers that might expect to receive large numbers of patients in a single incident should stock larger amounts of antidotes or have an effective and efficient drug sharing/transfer procedure in place to rapidly obtain additional antidotal supplies. For medical centers choosing to stock antidotes, the suggested stocking level is based on the dose needed to treat a single 100 kg patient for 8 hours and for 24 hours.
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