Inhibition of this cytochrome prevents the cell from using oxygen and forces anaerobic metabolism, resulting in lactate production, cellular hypoxia, and metabolic acidosis. Cyanide binds rapidly with cytochrome a3 in the mitochondria. Inhalation, ingestion or dermal exposure to cyanide-containing compounds may cause cyanide poisoning. Cyanokit contains hydroxocobolamin, the hydroxylated active form of vitamin B 12 ,an antidote indicated for the treatment of cyanide poisoning. *This quantity is not intended to represent a recommended par level nor is it a required amount to have on hand at all facilities.Cyanokit was FDA approved about a month ago. INR >= 10 with no bleeding: 2.5-5 mg PO (Note: may be significantly higher for long-acting vitamin K antagonists) Wernicke-Korsakoff Syndrome, ethylene glycolġ0 g (1 packet) PO Q 6 hours for 20 doses Isoniazid, hydrazines, Gyromitra mushroomsġ00 mg IV daily (ethylene glycol toxicity) 500 mg IV Q8H (Wernicke-Korsakoff syndrome) NOTE: patients normally require at least 30 days of treatment To reverse life-threatening bleeding associated with exposure to warfarins, brodifacoum, hydroxycoumarins, other anticoagulants (apixaban, dabigatran, rivaroxaban, edoxaban, etc.) Prothrombin complex concentrate, human (PCC) (Kcentra, FEIBA, etc.) MAINTENANCE: 10-20 mg/kg/hr (max 500 mg/hour)ġ-1.5 mg to reverse each 100 units of heparin LOAD: 20-40 mg/kg (max 2 g) IV over 30 minutes MAINTENANCE: 8-10 mg/kg/hour (max 500 mg/hour) LOAD: 30 mg/kg (max 2 g) IV over 30 minutes Pediatric: Initiate NG infusion at 5-10 mL/kg/hour and titrate up to 25 mL/kg/hour Polyethylene glycol electrolyte lavage solution (Golytely, Colyte)Īdult: 500 mL/hour titrated up by 500 mL/hour Q 30 minutes to a goal rate of 2 L/hour PO or NG Internal contamination with plutonium, americium, or curium Pentetate calcium trisodium (calcium-DTPA) Lead, mercury, arsenic, copper, antimony, bismuth, gallium, gold, palladium, polonium
Pediatric: 1-1.25 mcg/kg SQ up to 50 mcg/dose (or if given IV, diluted in 50 mL D5W or NS and given over 15-30 minutes) Valproic acid-induced hyperammonemic encephalopathyġ-2 mg/kg IV over 5 minutes, may repeat in 30-60 minutes (max 7 mg/kg/day)Ġ.4-10 mg IV Q 15-45 minutes or by continuous infusionĢ-4 mg IN, alternate nostrils Q 1-5 minutesĠ.4-2 mg IM repeated every 2-3 minutes as needed
MAINTENANCE: 15 mg/kg (max 3000 mg) IV Q 4 hours LOAD: 100 mg/kg IV (max 6000 mg given over 30 minutes) Severe intoxication with lipophilic drug (cyclic antidepressants, bupropion, calcium channel blockers, beta blockers) INFUSION: 1-10 unit/kg/hour continuous IV infusion MAINTENANCE: 10 mg/kg IV Q 12 hours for 4 doses then 15 mg/kg IV Q 12 hours thereafterĥ g IV given as two consecutive 2.5 g IV boluses Lead, mercury, arsenic, gold, antimony, bismuth, lead, nickel, polonium x weight (kg)/100 kg = # of vialsĮach vial is expected to bind 500 mcg of ingested digoxinĭimercaptosuccinic acid (DMSA) (succimer, Chemet)ġ0 mg/kg PO TID for 5 days then 10 mg/kg PO BID for 14 daysģ-5 mg/kg IM Q 4-6 hours (contraindication peanut allergy) Iron, aluminum, manganese, neptunium, plutoniumĭigoxin, cardiac glycosides (oleander, foxglove, red squill, bufo toad)
Pediatric: 0.25 mg/kg/day in 4 divided dosesġ-2.5 mg/kg IV (repeat until symptoms subside)(max 10 mg/kg)ĭantrium (20 mg/vial): 35 vials Ryanodex (250mg/vial): 3 vials MAINTENANCE: 1-4 mg IV once or twice/daily (max 6 mg/day)Ĭadmium, chromium, cobalt, copper, iridium, lead, manganese, mercury, nickel, plutonium, ruthenium, yttrium, zinc, zirconiumĬalcium channel blockers, hydrofluoric acidĬyanide Antidote Kit (Nithiodote) (also see hydroxocobalamin)Īdult: 12 mg PO or NG initially then 8 mg Q 6 hours (32 mg max/day) Organophosphate, carbamate insecticides, muscarine containing mushroomsġ-2 mg IV or IM (can repeat up to 4 mg initially) Pediatric: 0.05-0.1 mg/kg/dose IV Q 5-15 minutes Per manufacturer recommendation based on last dose of factor Xa inhibitorįactor Xa inhibitor direct-acting oral anticoagulantĪdult: 1-3 mg IV bolus, repeat 1-5 mg IV Q 2-20 minutes
Amanita phalloides), chloroform, carbon tetrachloride, pennyroyal oilĪll oral ingestions besides hydrocarbons, alcohols, metals, corrosives, and foreign objects Quantity to Treat One 70 kg Patient for 24 Hours*īlack Widow Spider Antivenin (Lactrodectus mactans) (equine)ġ vial in 10-50 mL 0.9% sodium chloride IV over 15 minutesĬoral Snake Antivenin (Micrurus fulvius) (equine)Įastern or Texas coral snake envenomationĬrotalidae Polyvalent Immune F(ab’)2 (equine) (AnaVip®)Ĭrotalidae Polyvalent Immune Fab (ovine) (CroFab®)Īcetaminophen, cyclopeptide containing mushrooms (e.g. The information herein is intended for educational purposes and should not be used to supersede clinical judgement or toxicologic consultation. There are multiple factors that affect a patient’s presentation and treatment options.
0 kommentar(er)
