An antidote is a substance that can counteract a form of poisoning.[1] The term ultimately derives from the Greek term φάρμακον ἀντίδοτον (pharmakon) antidoton, "(medicine) given as a remedy". Antidotes for anticoagulants are sometimes referred to as reversal agents.[2]

The antidotes for some particular toxins are manufactured by injecting the toxin into an animal in small doses and extracting the resulting antibodies from the host animals' blood. This results in an antivenom that can be used to counteract venom produced by certain species of snakes, spiders, and other venomous animals. Some animal venoms, especially those produced by arthropods (such as certain spiders, scorpions, and bees) are only potentially lethal when they provoke allergic reactions and induce anaphylactic shock; as such, there is no "antidote" for these venoms; however anaphylactic shock can be treated (e.g. with epinephrine).

Some other toxins have no known antidote. For example, the poison aconitine – a highly poisonous alkaloid derived from various aconite species – has no antidote, and as a result, is often fatal if it enters the human body in sufficient quantities.

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Mechanical approachesEdit

Ingested poisons are frequently treated by the oral administration of activated charcoal, which adsorbs the poison and flushes it from the digestive tract, thereby removing a large part of the toxin. Poisons which are injected into the body (such as those from bites or stings from venomous animals) are usually treated by the use of a constriction band which limits the flow of lymph and/or blood to the area, thus slowing the circulation of the poison around the body. This should not be confused with the use of a tourniquet which cuts off blood flow completely – often leading to the loss of the limb.

Techniques to identify antidotesEdit

In early 2019, a group of researchers in Australia published the finding of a new box jellyfish venom antidote using CRISPR.[3] The technology had been used to functionally inactivate genes in human cell lines and identify the peripheral membrane protein ATP2B1, a calcium transporting ATPase, as one host factor required for box jellyfish venom cytotoxicity.[4]

List of antidotesEdit

Agent Indication
Activated charcoal with sorbitol Used for many oral toxins
Theophylline Adenosine poisoning
Antimuscarinic (e.g. Atropine) Organophosphate and carbamate insecticides, nerve agents, some poison mushrooms
Beta blocker Theophylline
Calcium chloride[5] Calcium channel blocker toxicity,[5] black widow spider bites
Calcium gluconate [5] Calcium channel blocker toxicity,[5] hydrofluoric acid
Chelators such as EDTA, dimercaprol (BAL), penicillamine, and 2,3-dimercaptosuccinic acid (DMSA, succimer) Heavy metal poisoning
Cyanide antidote (hydroxocobalamin, amyl nitrite, sodium nitrite, or thiosulfate) Cyanide poisoning
Cyproheptadine Serotonin syndrome
Deferoxamine mesylate Iron poisoning
Digoxin Immune Fab antibody (Digibind and Digifab) Digoxin poisoning
Diphenhydramine hydrochloride and benztropine mesylate Extrapyramidal reactions associated with antipsychotics
Ethanol or fomepizole Ethylene glycol poisoning and methanol poisoning
Flumazenil Benzodiazepine overdose
Glucagon Beta blocker poisoning and calcium channel blocker poisoning
100% oxygen or hyperbaric oxygen therapy (HBOT) Carbon monoxide poisoning and cyanide poisoning
Idarucizumab Reversal of dabigatran etexilate, an anticoagulant
Insulin with Glucagon Beta blocker poisoning and calcium channel blocker poisoning
Leucovorin Methotrexate and trimethoprim
Methylene blue Treatment of conditions that cause methemoglobinemia
Naloxone hydrochloride Opioid overdose
N-acetylcysteine Paracetamol (acetaminophen) poisoning
Octreotide Oral hypoglycemic agents
Pralidoxime chloride (2-PAM) Organophosphate insecticides, followed after[clarification needed] atropine
Protamine sulfate Heparin poisoning
Prussian blue Thallium poisoning
Physostigmine sulfate Anticholinergic poisoning
Pyridoxine Isoniazid poisoning, ethylene glycol
Phytomenadione (vitamin K) and fresh frozen plasma Warfarin poisoning and indanedione
Sodium bicarbonate Aspirin, TCAs with a wide QRS[clarification needed]
Succimer, chemical name Dimercaptosuccinic acid (DMSA) Lead poisoning

See alsoEdit

ReferencesEdit

  1. ^ "antidote" at Dorland's Medical Dictionary .
  2. ^ Christos S, Naples R (2016). "Anticoagulation Reversal and Treatment Strategies in Major Bleeding: Update 2016". West J Emerg Med. 17: 264–70. doi:10.5811/westjem.2016.3.29294. PMC 4899056. PMID 27330657.
  3. ^ The-Crispr (2019-05-13). "Antidote to deadly jellyfish identified using CRISPR". The Crispr. Retrieved 2019-08-08.
  4. ^ Neely, G. Gregory; Seymour, Jamie E.; Hesselson, Daniel; Nguyen, David T.; Qiao-Ping Wang; Khuong, Thang M.; Oyston, Lisa; Littleboy, Jamie B.; Manion, John (2019-04-30). "Molecular dissection of box jellyfish venom cytotoxicity highlights an effective venom antidote". Nature Communications. 10 (1): 1–12. doi:10.1038/s41467-019-09681-1. ISSN 2041-1723.
  5. ^ a b c d "Calcium channel blocker poisoning". UpToDate. Retrieved 2019-07-09.