Antidotes for toxicological emergencies: A practical review

Marraffa, Jeanna M.; Cohen, Victor; Howland, Mary Ann

doi:10.2146/ajhp110014

Cited by 63 publications

(54 citation statements)

References 138 publications

(173 reference statements)

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“…7,13 In such situations, the first-option emergency antidote is hydroxocobalamin. 7,13 Ethanol is an effective alternative to fomepizole for treating methanol/ethylene glycol poisoning. On the other hand, despite the high cost of fomepizole, it is much simpler to use than ethanol.…”

Section: Discussionmentioning

confidence: 99%

Antidote availability in the municipality of Campinas, São Paulo, Brazil

et al. 2017

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CONTEXT AND OBJECTIVE: The lack of availability of antidotes in emergency services is a worldwide concern. The aim of the present study was to evaluate the availability of antidotes used for treating poisoning in Campinas (SP). DESIGN AND SETTING: This was a cross-sectional study of emergency services in Campinas, conducted in 2010-2012. METHODS:The availability, amount in stock, place of storage and access time for 26 antidotal treatments was investigated. In the hospitals, the availability of at least one complete treatment for a 70 kg adult over the first 24 hours of admission was evaluated based on stock and access recommendations contained in two international guidelines. RESULTS: 14 out of 17 functioning emergency services participated in the study, comprising pre-hospital services such as the public emergency ambulance service (SAMU; n = 1) and public emergency rooms for admissions lasting ≤ 24 hours (UPAs; n = 3), and 10 hospitals with emergency services. Six antidotes (atropine, sodium bicarbonate, diazepam, phytomenadione, flumazenil and calcium gluconate) were stocked in all the services, followed by 13 units that also stocked activated charcoal, naloxone and diphenhydramine or biperiden. No service stocked all of the recommended antidotes; only the regional Poison Control Center had stocks close to recommended (22/26 antidotal treatments). The 10 hospitals had almost half of the antidotes for starting treatments, but only one quarter of the antidotes was present with stocks sufficient for providing treatment for 24 hours. CONCLUSION: The stock of antidotes for attending poisoning emergencies in the municipality of Campinas is incomplete and needs to be improved. RESUMO

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Section: Discussionmentioning

confidence: 99%

Antidote availability in the municipality of Campinas, São Paulo, Brazil

et al. 2017

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“…Nitrite is currently only approved as an antidote to cyanide poisoning [62], but is being investigated as a therapy for several conditions where ischemia or hypoxia is of concern. Potential concerns with nitrite therapy are that it can affect blood pressure or cause methemoglobinemia [63], so it requires close monitoring.…”

Section: Nitrite As a Potential Therapeutic Agentmentioning

confidence: 99%

Inorganic Nitrite as a Potential Therapy or Biomarker for Concussion

Silver¹

2016

J Neurol Neurophysiol

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One of the hallmarks of concussion is a disturbance, typically a reduction, in cerebral blood flow. Studies have shown a rapid increase in nitric oxide within minutes following head injury, followed by a decline to below baseline within hours. This reduction in nitrite levels is closely linked to a reduction in cerebral blood flow. Inorganic nitrite has recently been shown to be a source of nitric oxide under conditions of ischemia or hypoxia, and has been shown to increase cerebral blood flow and to improve neurovascular coupling. Dietary nitrate has been shown to be converted to nitrite in the bloodstream. This review suggests that inorganic nitrite, and/or dietary nitrate, should be investigated for their potential in treating concussion symptoms.

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“…The acceptance rate of prescribers was 84% and their satisfaction was high. Pharmacotherapy expertise during medical rounds was useful and well accepted by prescribers" [7].…”

Section: Emergency Med Pharmacist Role and Icumentioning

confidence: 99%

Pharmaceutical Care and Toxicology, a Synergy in High Risk Situation

Luisetto¹

2016

J App Pharm

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The rationale of this works is to analyse relationship in field of poisoning and toxicology between pharmaceutical care approach in order to improve the global management of the system and improving clinical outcomes in high risk situations. Observing the roles played by clinical pharmacy in toxicology medical team we can have relevant improving in the management of the systems. Starting from the analysis of some relevant literature we submit to international organization a rethinking about the toxicological medical team organization with a stabile presence of clinical pharmacist. Poisoning therapy is a multidisciplinary bio-medical work and we have more benefit when clinical pharmacist is permanent member of toxicology team.

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Antidotes for toxicological emergencies: A practical review

Abstract: Pharmacists can play a key role in reducing poisoning and overdose injuries and deaths by assisting in the early recognition of toxic exposures and guiding emergency personnel on the proper storage, selection, and use of antidotal therapies.

Cited by 63 publications

References 138 publications

Antidote availability in the municipality of Campinas, São Paulo, Brazil

Antidote availability in the municipality of Campinas, São Paulo, Brazil

Inorganic Nitrite as a Potential Therapy or Biomarker for Concussion

Pharmaceutical Care and Toxicology, a Synergy in High Risk Situation

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