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Additional Drug Overdoses and Treatments (A-L) Cheat Sheet (DRAFT) by

This is a draft cheat sheet. It is a work in progress and is not finished yet.

ANTICH­OLI­NERGICS

DRUG OVERDOSE
TREATMENT
Anticholinergics
   Atropine
   Diphenhydramine
   Dimenhydrinate
   Atropa belladonna

   (deadly nightshade)

   Jimson weed
   Scopolamine
- Supportive care
- Physostigmine (rarely)

ANTICO­AGU­LANTS

DRUG OVERDOSE
TREATMENT
WARFARIN
Vit K
WARFARIN, FACTOR XA-I
Kcentra 
(proth­rombin complex conc)
DTI
Idaruc­izumab
   
(Praxbind)
HEPARIN, LMWH
Protamine

BZDS & BETA BLOCKERS

DRUG OVERDOSE
TREATMENT
BZDs
- Flumazenil 
(romaz­icon)

    - Causes seizures in BZD-de­pendent pts
    - Off-label use: non-BZD hypnotic overdose (zolpidem) but isn't routinely recomm­ended
BETA BLOCKERS
- Supportive care (1st line)
- Glucagon (2nd line)
- High dose Insulin w/ glucose (refra­ctory to ↑)
- Lipid Emulsion
   - Enhances elimin­ation of some lipophilic drugs

CCBs & CYANIDE

DRUG OVERDOSE
TREATMENT
CCBs
- Supportive care
- Calcium 
(chloride or gluconate)

   - IV only
   - Monitor ECG
   - Do NOT infuse in same line as phos-containing soln
CYANIDE
- Hydrox­yoc­oba­lamin
   
(cyanokit)

- Na thiosu­lfate + Na nitrate
   
(Nithi­odote)
Cyanide: smoke inhala­tion, nitrop­russide in high doses and for long duration

DIGOXIN, OLEANDER, FOXGLOVE

DRUG OVERDOSE
TREATMENT
DIGOXIN
Oleander
Foxglove
-Digoxin Immune Fab 
(Digifab)

    - 40 mg vial binds ~0.5 mg digoxin
    - max adult dose is 20 vials

ETHANOL, ETHYLENE GLYCOL, ETC

DRUG OVERDOSE
TREATMENT
ETHANOL
 ­ ­(al­cohol)
Thiamine
   - Prevents Wernicke enceph­alo­pathy
ETHYLENE GLYCOL
  
(antif­reeze)

DIETHYLENE GLYCOL
METHANOL
Fomepizole 
(Antizol)

   -
preferred

Ethanol (2nd line)

5-FLUO­ROU­RACIL (5-FU), CAPECI­TABINE

5-FU
CAPECI­TABINE
Uridine triacetate
   
Vistogard, Xuriden

HEAVY METALS

ARSENIC, GOLD, MERCURY
Dimerc­aprol or
Lead + CaNa2 EDTA
COPPER
Penici­llamine
LEAD
Succimer 
(chemet)
or
DMSA 
(dimer­cap­tos­uccinic acid)
THALLIUM
Ferric hexacy­ano­ferrate 
(Prussian blue[r­adi­oga­rdase])
 

INSULIN (OTHER HYPOGLYS), ISONIAZID, IRON, ETC

INSULIN & OTHER HYPOGL­YCEMICS
Dextrose (1st line)
   -Drip
   - IV or infusion
Glucagon (2nd line)
SULFON­YLUREA
INDUCED-HYPOGLYCEMIA
Octreotide 
(Sando­STATIN)
ISONIAZID
Pyridoxine
(vit B6)
, BZDs, and/or barbit­urates
     - Acute neurot­oxi­city: IV pyridoxine
     - 10-50 mg PO QD pyridoxine is used w/ isoniazid to prevent neurop­athies
IRON
ALUMINUM
Iron overload from blood transfusions:
     Deferoxamine 
(Deferral)

     Deferiprone 
(Ferriprox)

          and
      Deferasirox 
(Exjade, Jadenu)


Deferoxamine is contraindicated in severe renal disease

INSULIN (OTHER HYPOGLYS), ISONIAZID, IRON, ETC

INSULIN & OTHER HYPOGL­YCEMICS
Dextrose (1st line)
   -Drip
   - IV or infusion
Glucagon (2nd line)
SULFON­YLUREA
INDUCED-HYPOGLYCEMIA
Octreotide 
(Sando­STATIN)
ISONIAZID
Pyridoxine
(vit B6)
, BZDs, and/or barbit­urates
     - Acute neurot­oxi­city: IV pyridoxine
     - 10-50 mg PO QD pyridoxine is used w/ isoniazid to prevent neurop­athies
IRON
ALUMINUM
Iron overload from blood transfusions:
     Deferoxamine 
(Deferral)

     Deferiprone 
(Ferriprox)

          and
      Deferasirox 
(Exjade, Jadenu)


Deferoxamine is contraindicated in severe renal disease

LOCAL ANETHETICS

Bupiva­caine
Mepiva­caine
Ropiva­caine
Other lipophilic drugs
Supportive care
Lipid emulsion 20%
BZDs if seizures

LOCAL ANETHETICS

Bupiva­caine
Mepiva­caine
Ropiva­caine
Other lipophilic drugs
Supportive care
Lipid emulsion 20%
BZDs if seizures