Antidotes

TOXIN	ANTIDOTE
Acetaminophen	N-Acetylcysteine 150mg/kg IV load over 60min; followed by 50mg/kg IV over 4hr and then 100mg/kg IV over 16hr
Anticholinergics	Physostigmine
Arsenic	Dimercaprol (BAL)
Benzodiazepines	Flumazenil Adult: 0.2mg IV Peds: 0.01mg/kg IV
Beta blockers	Glucagon Adult: 3-10mg IV Peds: 50-150mcg/kg IV
Ca channel blockers	Calcium chloride 10% Adult: 10 mL IV Peds: 0.2-0.25 mL/kg IV High Dose Insulin (1 unit/kg/hr)
Clonidine	Naloxone Adult: 0.4-2mg IV Peds: 0.1mg/kg IV (max 2mg)
Cyanide	Hydroxocobalamin OR Cyanokit (Amyl Nitrite, Sodium Nitrite, and Sodium Thiosulfate)
Dabigatran	Idarucizumab 5mg IV
Digoxin	Dig Immune Fab
Ethylene glycol	Fomepizole 15mg/kg IV; then 10mg/kg q12h
Factor Xa Inhibitor (e.g. apixaban, rivaroxaban	Andexanet alfa 4-factor PCC
Fluoride	Calcium gluconate
Heparin	Protamine sulfate Adult: 25-50mg IV (empiric dose) over 10 minutes Peds: 0.6mg/kg IV (empiric dose) Note: Rapid protamine infusion causes hypotension
Iron	Deferoxamine
Isoniazid (INH)	Pyridoxine (Vit B6) Adult: 5gm IV Peds: 1gm/kg regardless of age
Lead	EDTA, succimer
Mercury	Dimercaprol (BAL)
Methanol	Fomepizole 15mi/kg IV; then 10mg/kg q12h
Methemoglobinemia	Methylene blue
Methotrexate toxicity	Glucarpidase
Opioids	Naloxone
Organophosphates	Atropine + Pralidoxime
Sulfonylurea	Octreotide Adult: 50–100mcg SC q6hr Peds: 1mcg/kg SC q6hr
Tricyclic (TCA) Toxicity	Bicarbonate 1-2mEq/kg IV bolus followed by 2mEq/kg/hr IV infusion
Valproate	L-carnitine
Warfarin	Vitamin K, FFP, Prothrombin complex concentrate

References

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