Drugs such as N-acetyl cysteine and sodium thiocyanate reduce the formation of toxic metabolites in paracetamol and cyanide poisoning respectively. naloxone, flumazenil) are other mechanisms by which antidotes act. oximes for organophosphorus poisoning) and competitive receptor blockade (e.g.
ethanol for methanol poisoning), enhancement of enzyme function (e.g. In some situations, enhanced elimination can be achieved by urinary alkalization or hemadsorption. Specific binders include chelating agents, bioscavenger therapy and immunotherapy. The most commonly used non-specific binding agent is activated charcoal. Reduction in free toxin level can be achieved by specific and non-specific agents that bind to the toxin. Antidote administration may not only result in the reduction of free or active toxin level, but also in the mitigation of end-organ effects of the toxin by mechanisms that include competitive inhibition, receptor blockade or direct antagonism of the toxin. Antidotes mediate its effect either by preventing the absorption of the toxin, by binding and neutralizing the poison, antagonizing its end-organ effect, or by inhibition of conversion of the toxin to more toxic metabolites. 39(9):2644-91, 2008 Sep.Antidotes are agents that negate the effect of a poison or toxin. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Council on Cardiovascular Disease in the Young. American Heart Association Stroke Council.
Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Monagle P, Chan AKC, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-Gottl U, Vesely SK. Lexi-Drugs Online/Pediatric Lexi-Drugs Online, Enoxaparin,, Copyright © 1978-2008 Lexi-Comp, Inc, Hudson, OH 44236 Obtain blood for an PTT and PT 15 minutes after the administration of protamine.Įxcessive Protamine doses may worsen bleeding potential.ĭavid, M., et al. Patients with hypersensitivity to fish and those who have received protamine-containing insulin or previous protamine therapy may be at risk of hypersensitivity reactions. More rapid infusion may result in hypotension. Infusion rate should not exceed 5 mg/min. Protamine should be given IV over 10 minutes. Table 2-Protamine sulfate for immediate reversal Time since last heparin dose
The dose of protamine is based on the amount of heparin administered in the previous 2 hours using Table 2. If immediate reversal is required protamine sulfate will result in neutralization of heparin. Termination of the IV infusion generally will terminate the anticoagulant effect.
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