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

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 poison produced by certain species of snakes, spiders, and other venomous animals. Some animal venoms, especially those produced by arthropods (e.g., certain spiders, scorpions, bees, etc.) are only potentially lethal when they provoke allergic reactions and induce anaphylactic shock; as such, there is no "antidote" for these venoms because it is not a form of poisoning and anaphylactic shock can be treated (e.g., by the use of 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.

Mechanical approaches

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 circulation of the poison around the body. This should not be confused with use of a tourniquet which cuts off blood flow completely - often leading to the loss of the limb.

List of antidotes

Agent Indication
Activated charcoal with sorbitol used for many oral toxins
Theophylline adenosine poisoning
Atropine organophosphate and carbamate insecticides, nerve agents, some poison mushrooms
Beta blocker theophylline
Calcium chloride calcium channel blockers, black widow spider bites
Calcium gluconate 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 antipsychotic
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 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
Succimer, chemical name Dimercaptosuccinic acid (DMSA) lead poisoning

See also


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