Antidotes
For a severely poisoned patient, PPE may be required.
The patients should be resuscitated and atropine given to a point where the pupils are just starting to dilate and bronchospasm stops. This may require repeating as the half-life of many organophosphates is longer than the Atropine.
Pralidoxime has a longer time of effect and may be used for poisoning with organophosphorus compounds with anticholinesterase activity.
Other toxins and their antidotes include the following:
| Toxin | Toxidrome | Antidote |
|---|---|---|
| Organophosphates | Pinpoint pupils, drooling saliva, urination, diarrhoea, and emesis | Atropine and Pralidoxime |
| Carboxyhaemoglobin | Normal pupil size, pink or cyanosed skin, decreased conscious level and decreased respiratory rate | Oxygen |
| Hydrogen Sulphide | Mydriasis, cyanosis and increased respiratory rate | Sodium Nitrite |
| Methaemoglobin | Normal pupil size, cyanosis despite good oxygenation and decreased respiratory rate | Methylene Blue |
| Hydrofluoric acid | Rapid onset severe pain and erythema | Calcium Gluconate |