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California poison control system

California Poison Control System
ANTIDOTE CHART
(Suggested Stocking Level is based on dose to treat a 70 kg patient for 24 hours)*
May require large amounts in
Organophosphate/Carbamate
severe cholinesterase inhibitor
insecticide poisoning and
poisoning. Also stocked in the
1000 mg total (in vials)
other cholinesterase
Atropine
Strategic National Stockpile but
Use preservative free
inhibitors (eg, warfare
will need supplies for first 48
agents); bradycardia induced
hours. Coordinate with local
by a variety of toxins
Homeland Security office.
Antivenom, Crotalidae Polyvalent
24 vials, may need up to
Rattlesnake envenomation
Immune-FAB(ovine)/ Cro-Fab®
35 vials for treatment
Antivenom, Black Widow Spider/
Black Widow Spider
Antivenom (Latrodectus
1 x 6000u vial
envenomation
Mactans)®
BAL(Dimercaprol)/ BAL in oil
6 x 3 mL (10% in oil)
Heavy Metal poisoning
Calcium channel blocker
Can cause tissue necrosis if
Calcium Chloride injection
poisoning; hypocalcemia
extravasation occurs – use large
20 x 10mL (10%) vials
induced by various agents
vein for infusion.
Calcium Gluconate Powder
Hydrofluoric Acid
For manufacture of topical gel
1 x 100gm powder bottle
Hydrofluoric Acid skin
exposure or poisoning;

Calcium Gluconate injection
20 x 10mL (10%) vials
hypocalcemia induced by
various agents

Calcium Gluconate gel/Calgonate
Hydrofluoric Acid dermal
For topical burns
6 x 25 gm tubes
2.5% gel®
Hyperammonemia from
Carnitine (L-Carnitine)/ Carnitor®
7 x 1gm vials
valproic acid toxicity
Deferoxamine/ Desferal®
Iron poisoning
IM administration is discouraged.
12 x 500mg vials
Digoxin poisoning; Other
Consult with poison center
Digoxin Immune FAB (ovine)/
15 vials of either
cardiac glycosides (eg,
regarding dosing, especially for
Digibind® or DigiFab®
oleander, foxglove)
cardiac glycosides than digoxin.
DMSA (Succimer)/ Chemet®
Heavy metal poisoning
1 x 100 capsule bottle
DTPA-Calcium
Stocked in the Strategic National
Dirty bomb agents:
(Diethylenetriamine pentaacetate)/
Stockpile but will need supplies
Radioactive plutonium,
1 x 1gm vial
Pentetate Calcium Trisodium
for first 48 hours. Coordinate with
americium and curium
injection)
local Homeland Security office.
Stocked in the Strategic National

DTPA-Zinc (Diethylenetriamine
Dirty bomb agents:
Stockpile but will need supplies
pentaacetate)/ Pentetate Zinc
Radioactive plutonium,
1 x 1gm vial
for first 48 hours. Coordinate with
Trisodium injection)
americium and curium
local Homeland Security office.
EDTA-Calcium/ Versenate®
Heavy metal poisoning
18x 1000mg/5mL amps
Fomepizole easier to dose and
Note: IV 10% ethanol
Ethanol IV 10%
Ethylene glycol or Methanol
monitor than ethanol. Oral ethanol
product no longer
poisoning
can be used in an emergency
manufactured
situation.
Fomepizole easier to dose and

Ethylene glycol or Methanol
monitor than ethanol. Oral ethanol
Ethanol (oral) / Vodka
One 750ml bottle
poisoning
can be used in an emergency
situation.

Use small initial dose to avoid
Flumazenil/ Romazicon®
Benzodiazepine poisoning
5 x 0.5 mg/5mL vials
abrupt awakening/ delirium.
Preferred antidote for
Manufacturer will replace expired
4 x 1.5mL (1gm/mL)
Fomepizole (4-MP)/ Antizol®
Ethylene glycol or Methanol
poisoning
Beta blocker/ Calcium
Glucagon
Anticipate nausea and vomiting.
10 x 1 mg vials
channel blocker poisoning
Safer to use than the conventional
3 x 5gm kits (or stock
Hydroxycobalamin/ Cyanokit®
Cyanide poisoning
cyanide antidote kit from Taylor.
the Taylor cyanide kit)
5 x 10mL (1%) amps
Methylene Blue
Methemoglobinemia
(10mg/mL)
N-Acetylcysteine (NAC)
Acetaminophen poisoning
Use orally. Dilute at least by a 3:1
7 x 30mL (20%) vials
Mucomyst® or generic
(oral preparation)
Loading dose should be infused
slowly over 45-60 minutes.

N-Acetylcysteine (NAC)
Acetaminophen poisoning
Generic N-acetylcysteine can be
1 carton of 4 x 30mL
Acetadote®
(IV preparation)
used if Acetadote® is not available
(20%) vials
(consult with poison center and
give via micropore filter).

Use small initial dose to avoid
20 x 0.4mg/2mL amps or
Naloxone/ Narcan®
Opioid overdose
abrupt awakening/ delirium.
10 x 10mg/10mL vials
2 x 1mL (0.1mg/mL)
Octreotide acetate/ Sandostatin®
Oral sulfonylurea poisoning
Avoid long-acting depot products.
amps
1 x 5ml 0.2mg/1ml MDV

Possible cross-sensitivity in
1500mg, 1 bottle 250mg
D-Penicillamine/ Cupramine®
Heavy metal poisoning
patients allergic to penicillin
capsules
Anticholinergic poisoning,
Administer slowly: May cause
Physostigmine/ Antilirium®
especially antimuscarinic
severe side effects including
10 x 2mL (1mg/mL) vials
delirium.
bradycardia, asystole and seizures
Also stocked in the Strategic

Cholinesterase Inhibitor
National Stockpile but will need
Pralidoxime(2-PAM)/ Protopam®
poisoning (organophosphate
supplies for first 48 hours.
12 x 1gm (20mL) vials
or “nerve gas”)
Coordinate with local Homeland
Security office.

Dirty bomb agents:
Stocked in the Strategic National
radioactive cesium and
Stockpile but will need supplies
2 packs of thirty 500 mg
Prussian Blue/ Radiogardase®
thallium and non-radioactive
for first 48 hours. Coordinate with
capsules
thallium
local Homeland Security office.
Large amounts needed for
poisoning: 5 grams is the
minimum antidotal dose used in

50 x 1mL (100 mg/mL) or
an ingestion of an unknown
the equivalent (Use
Pyridoxine (Vitamin B6)
Isoniazid (INH) poisoning
amount. Note: the 100 mg in 1 ml
preservative free
vials contain the preservative
product.)
chlorobutanol. A 5 gram dose
requires 50 vials and will deliver a
toxic dose of the preservative.
Kit contains 2-10ml amps of
sodium nitrite, 2-50ml vials of

Taylor Cyanide Antidote Kit
sodium thiosulfate, 12 amyl nitrite
inhalant ampules

Warfarin, warfarin-based
Vitamin K
If patient is actively bleeding use
1(Phytonadione)/
anticoagulants and super-
20 x 5mg tabs
fresh frozen plasma or Factor VII
Mephyton® or AquaMephyton®
warfarin based rodenticide
10 x 10mg/mL amps
concentrate.
poisoning
Expert advice regarding use of antidotes is available 24 hours a day, 7 days a week from the California Poison Control System. Call us at 1-800-222-1222
*Adapted From Olson, KR (Ed): Poisoning & Drug Overdose. 5th Edition. McGraw-Hill. New York. 2007 Note: List is not all-inclusive but reflects agents used more exclusively as antidotes
or antidotal agents used infrequently.
Updated: 6-26-2009

Source: http://www.calpoison.org/hcp/CPCS%20antidote%20chart%206-2009.pdf

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