antidote administration powerpoint presentation

it mainly consists about carbamates and how it cause toxicity

1. ANTIDOTE ADMINISTRATION

2. DEFINITIONS TOXICOLOGY Science dealing with properties , actions ,toxicity , detection treatment and autopsy findings FORENSIC TOXICOLOGY It deals with medical and legal aspects of the harmful effects of the chemical s on human beings It involves not only the identification and the quantifying of the drug, poison or substance but also ability to interpret Results of ones findings

3. Classification of poisons Corrosives Irritants Neurotics Cardiac Strong acids HCL, HNO3 H2SO4 Oxalic acid Strong alkalis Caustic soda Potassium Ammonium Metallic salts Zncl , Fecl2 Organic Castor oil Snakes Scorpions Spiders Mechanical Inorganic As, sb, cu, pb, I, CCL4 Cerebral Opioids, alcohol Spinal Nuxvomica Selenium Peripheral Curare

4. ANTIDOTES Counteract the effect of poisons by neutralizing them or by antagonizing their physiologic effects MECHANICAL /PHYSICAL ANTIDOTES It neutralize the poisons by mechanical action ACTIVATED CHARCOAL Fine, black colourless powder produced by destructive distillation of various organic matter usually wood pulp and treated with high temperature Dose : 40-80mg with water MOA : It acts mechanically by adsorbing and obtaining the drugs and retaining the pores allowing toxin complex evacuated With stool . Uses : morphine, atropine, nicotine, alcohol , KCN, phenol

5. DEMULSCENTS form protective covering on the gastric mucus membrane Eg : milk, starch , Egg white and mineral oil and aluminium hydroxide Contraindications Kerosene Phosphorous DDT Phenol Aniline Ccl 4

6. CHEMICAL ANTIDOTES Sno chemicals procedure or uses 1 kmno4 It has oxidizing properties The wash must be continued until solution coming out of stomach is pink colour Alkaloids, barbiturates and phosphorous 2 Tannic acid In the form of strong tea precipitates Alkaloids, lead , silver , aluminum , cobalt 3 Dilute alkalis Milk of magnesia, alkaline hydroxide c 4 Common salt Reacts with AgNo3 5 Albumin Precipitates Hgcl2 and cuso4 UNIVERSAL ANTIDOTE Powdered charcoal – 2 parts Magnesium oxide - 1 part Tannic acid - 1 part

7. PHYSIOLOGICAL ANTIDOTES 1 . BRITISH ANTI LEWISITE USES : Arsenic Pb, cu Hg, Au Bismuth Heavy metal poisoning Dose : 10% in oil , 3-5 mg/kg IM 6 th hourly 2. EDTA USES Pb, cu Co, cd Fe, ni Excreted in urine Must be given IV 3. PENICILLAMINE Treatment of choice : cu, pb , Hg 4. DESFERRIOXAMINE used in acute iron poisoning , hemochromatosis and transfusional chronic iron overload

8. The international programme of chemical safety defines antidote as a therapeutic agent that counteracts Toxic actions of drug or toxin There are four basic mechanism Decreasing the active toxin level Blocking the site of action Decreasing the toxic metabolism Counteracting effects of toxin Clinical toxicology is a medical specialty focused on the prevention, assessment, and management of human exposures to drugs and chemicals, particularly in the context of poisoning. It involves the diagnosis and treatment of poisoni ngs , encompassing both acute and chronic cases, and often includes providing expert advice through poison information services

9. antidote Use Activated charcoal Most poisons Benztropine Dystonia Chlorpromazine Psychotic states Corticosteroids Laryngeal oedema Diazepam Convulsions Diphenhydramine Dystonia Dobutamine Myocardial depression Epinephrine Anaphylactic shock Furosemide Fluid retention Glucose Hypoglycemia Haloperidol Psychotic states Heparin Hypercoagulability Lidocaine Ventricular arrhythmia Pancuronium Convulsions Salbutamol Bronchoconstriction ADJUNCTUVAL ANTIDOTES

10. OBSOLETE ANTIDOTES ANTIDOTE DRUG Copper sulphate Phosphorous Cysteamine Paracetmol Diethyldithiocarbamate Thallium Fructose Ethanol Levallorphan Opiates Nalorphine Opiates Silbinin Amanitin Tocopherol Paraquat

11. SPECIFIC ANTIDOTES ANTIDOTE MAIN INDICATION OTHER Acetyl cysteine Paracetmol Amanitin Amyl nitrate Cyanide H2S Ascorbic acid Osmium Atropine Cholinergic agents Calcium salts Oxalates Dantrolene Hyperthermia Desferrioxamine Iron and aluminium Paraquat Diazepam Chloroquine Dicobalt edetate Cyanide Dimercaprol Arsenic Ethanol Methanol Flumazenil Benzodiazepines Glucagon Beta blockers Glucose Insulin Guanidine Botulism Hydroxycoablamin Cyanide

12. Methionine Paracetmol 4 methyl pyrazole Ethylene glycol. N acetyl penicillamine Mercury Naloxone Opiates Neostigmine Peripheral anticholinergics Oximes Organophosphates Oxygen Cyanide , CO,H2S Pentetic acid Radioactive metals Phentolamine Alpha adrenergics Vitamin K Coumarin derivatives Prussian blue Thallium Protamine sulphate Heparin ` Pyridoxine Isoniazid Sodium nitrile Cyanide Succimer Lead, mercury Tocopherol Carbon monoxide Trientiene Copper

13. In the majority of cases of acute poisoning, all that is required is intensive supportive therapy with attention to all the details mentioned in the preceding pages of this chapter. Specific antidotes are rarely necessary, besides the fact that only a few genuine antidotes exist in actual practice, though there is no denying the dramatic results that can be achieved with some of them in appropriate circumstances. Proper antidotal therapy can be life-saving in some situations. Ta ble 3.20: Toxins Removed by Haemoperfusion (more efficiently than haemodialysis ) Amanitin Paracetamol Barbiturates (all categories) Paraquat Carbon tetrachloride Phenols Chloral hydrate Phenylbutazone Chlorpromazine Promethazine Dapsone Propoxyphene Diazepam Quinidine, quinine Digoxin Salicylates Diphenhydramine Theophylline Organophosphates Tricyclic antidepressants Section 1  General Principles 26 Antidotes work in any one of a number of ways. Common modes of action are as follows :

14. Inert complex formation Some antidotes interact with the poison to form an inert complex which is then excreted from the body, e.g. chelating agents for heavy metals, Prussian Blue for thallium, specific antibody fragments for digoxin, dicobalt edetate for cyanide, etc. 2. Accelerated detoxification Some antidotes accelerate the detoxification of a poison, e.g. thiosulfate accelerates the conversion of cyanide to nontoxic thiocyanate, acetylcysteine acts as a glutathione substitute which combines with hepatotoxic paracetamol metabolites and detoxifies them. 3. Reduced toxic conversion The best example of this mode of action is provided by ethanol which inhibits the metabolism of methanol to toxic metabolites by competing for the same enzyme (alcohol dehydrogenase). 4. Receptor site competition Some antidotes displace the poison from specific receptor sites, thereby antagonising the effects completely. The best example is provided by naloxone, which antagonises the effects of opiates at stereo-specific opioid receptor sites. 5. Receptor site blockade This mode of action is best exemplified by atropine which blocks the effects of anticholinesterase agents such as organophosphates at muscarinic receptor sites. 6. Toxic effect bypass An example of this type of antidotal action is provided by the use of 100%