Common Drugs and Their Antidotes
An antidote is a substance that can counteract a form of poisoning. The term antidote is a
Greek word meaning “given against”. This post will help you familiarize yourself with the
common antidotes that are used in the hospital setting. The following are antidotes that should
be familiarized by the nurse to respond to this emergency situation quickly.
Table of Antidotes
Antidote Indication Mode of Action
Restores depleted glutathione
Acetaminophen/ Tylenol/
acetylcysteine (Mucomyst) stores and protects against renal
Paracetamol
and hepatic failure.
Non-specific poisons Absorption of drug in the gastric
except cyanide, iron, and intestinal tracts. Interrupts
Activated charcoal
lithium, caustics and the entero-hepatic cycle with
alcohol. multiple dose.
albuterol inhaler, insulin &
Potassium
glucose, NaHCO3, kayexalate
Neuromuscular blockade
anticholinesterase agents
(paralytics)
atropine sulfate or Competitive inhibition of
Anticholinesterase
pralidoxime muscarinic receptors.
Not known; partial protection
against acute hepatic failure;
Amanita phalloides (Death
Benzylpenicillin may displace amatoxin from
cap mushroom)
protein-binding sites allowing
increased renal excretion; may
also inhibit penetration of
amatoxin to hepatocytes.
Rapidly complexes with fluoride
Calcium salts Fluoride ingestion
ion.
Deferoxamine acts by binding
free iron in the bloodstream and
deferoxamine Iron
enhancing its elimination in
the urine.
Binds molecules of digoxin,
digibind making them unavailable for
Digoxin
digoxine immune fab binding at their site of action on
cells in the body.
Chelation of lead ions and
dimercapol, edetate
Lead endogenous metals (e.g., zinc,
calcium, disodium,
manganese, iron, copper).
A potent antagonist to
Extrapyramidal symptoms
diphenhydramine (Benadryl) acetylcholine in muscarinic
(EPS)
receptors.
Reverses the effects of
benzodiazepines by competitive
flumazenil Benzodiazepines inhibition at the benzodiazepine
binding site on the
GABAA receptor.
A competitive inhibitor of the
enzyme alcohol dehydrogenase
found in the liver. This enzyme
fomepizole Ethylene glycol
plays a key role in the
metabolism of ethylene glycol
and methanol.
Beta blockers and calcium Stimulates the formation of
glucagon
channel blockers adenyl cyclase causing
intracellular increase in cycling
AMP and enhanced
glycogenolysis and elevated
serum glucose concentration.
Dextrose (the monosaccharide
glucose) is used, distributed and
stored by body tissues and is
Glucose (Dextrose 50%) Insulin reaction
metabolized to carbon dioxide
and water with the release of
energy.
Reverses hypercoagulable state
by interacting with antithrombin
III. Used in combination with
Heparin Ergotamine
vasodilator phentolamine or
nitroprusside to prevent
local thrombosis and ischemia.
Forms cyanocobalamin, a non-
Hydroxocobalamin Cyanide toxic metabolite that is easily
excreted through the kidneys.
Fluorouracil
leucovorin calcium Protects the healthy cells from
the effects of methotrexate
Methotrexate
while allowing methotrexate to
enter and kill cancer cells.
Magnesium sulfate calcium gluconate
A “chemoprotectant” drug that
mesna Cyclophosphamide reduces the undesired effects of
certain chemotherapy drugs.
Chemical producing severe Reduces methemoglobin
Methylene blue
methemoglobinemia. to hemoglobin.
Ifosamide-induced
encephalopathy.
Prevents or reverses the effects
of opioids including
nalmefene or naloxone Opioid analgesics
respiratory depression, sedation
and hypotension.
Naloxone is believed to
antagonize opioid effects by
competing for the µ, κ and σ
naloxone (Narcan) Narcotics
opiate receptor sites in the CNS,
with the greatest affinity for the
µ receptor.
Anticholinesterase which causes
Neostigmine Anticholinergics accumulation of acetylcholine at
cholinergic receptor sites.
Oxidizes hemoglobin to
methemoglobin which binds the
Nitrite, sodium and free cyanide and can enhance
Cyanide
glycerytrinitrate endothelial cyanide
detoxification by producing
vasodilation.
Copper, gold, lead,
Penicillamine Chelation of metal ions.
mercury, zinc, arsenic
Regitine produces an alpha-
adrenergic block of relatively
short duration. It also has direct,
but less marked, positive
phentolamine (Regitine) Dopamine
inotropic and chronotropic
effects on cardiac muscle and
vasodilator effects on vascular
smooth muscle.
phyostigmine or NaHCO3 Tricyclic antidepressants A reversible anticholinesterase
which effectively increases the
concentration of acetylcholine at
the sites of cholinergic
transmission.
Phytomenadione (Vitamin Bypasses inhibition of Vitamin K
Coumadin/Warfarin
K.) epoxide reductase enzyme.
Protamine that is strongly basic
combines with acidic heparin
protamine sulfate Heparin forming a stable complex and
neutralizes the anticoagulant
activity of both drugs.
Isoniazid, theophylline, Reverses acute pyridoxine
monomethyl deficiency by promoting GABA
Pyridoxine hydrazine. Adjunctive synthesis. Promotes the
therapy in ethylene glycol conversion of toxic metabolite
poisoning. glycolic acid to glycine.
Neutralizes venom by binding
with circulating venom
Snake anti-venin Cobra bite components and with locally
deposited venom by
accumulating at the bite site.
Prevents convertion of ferrous
Iron
to ferric.
Cardiotoxic drug affecting Decreases affinity of cardiotoxic
fast sodium channel drugs to the fast sodium
(TCA, cocaine) channel.
Sodium Bicarbonate
Promotes ionization of weak
Weak acids
acids.
Neutralization of hydrochloric
Chlorine gas inhalational
acid formed when chlorine gas
poisoning
reacts with water in the airways.
Replenishes depleted
thiosulphate stores by acting as
sulfur donor necessary for the
Sodium thiosulphate Cyanide conversion of CN-O to
thiocyanate through the action
of sulfur transferase enzyme
rhodanese.
Alcohol, Wernicke- Reverses acute thiamine
Korsakoff Syndrome deficiency
Thiamine
Adjunctive in ethylene Enhances detoxification of
glycol glyoxylic acid.
Chemicals causing
methemoglobinemia in Reduces methemoglobin to
Vitamin C
patients with G6PD hemoglobin.
deficiency
Note: These were taken on the internet. Credits to the rightful owner
https://nurseslabs.com/list-of-common-drugs-their-antidotes-that-nurses-should-know/
