ANTIDOTE TOXIC EXPOSURE INDICATION DOSE LAB MONITORING ADVERSE RXNS COMMENTS

N-Acetylcysteine Acetaminophen  Acute ingestion of: PO:  AST  Nausea, vomiting, other GI  Do not draw APAP levels before 4
NAC - 7.5 g (adults) or  Loading Dose: 140 mg/kg  ALT symptoms with PO dosing. hrs post acute ingestion as they are
(Mucomyst) - 150 mg/kg (chikdren)  Maintenance dose: 70 mg/kg q4h x 17 doses  Bilirubin  Rash, pruritus, tachycardia, not predictive of toxicity
 Serum APAP level  Each dose should be diluted to final concentration of 5% with PO fluid of choice  PT HTN, hypotension and  If the px vomits w/in 1hr of an oral
- 150 mg/L at 4 hrs post ingestion  Creatinine bronchospasm have been NAC dose, repeat the dose. Use
 Chronic ingestion of potentially IV:  BUN reported, but are rare and more antiemetics as needed.
toxic amounts  Loading Dose: 140 mg/kg  Blood glucose and associated with IV administration
 Maintenance dose: 70 mg/kg q4h x 12 doses  Electrolytes
 Dilute dose in an appropriate crystalloid solution to a final conc. of *should be checked daily
3.3%-4% and infuse over 1 hr as part of maintenance fluids during NAC therapy
Antivenin, Crotaline snake  Mild, moderate or severe  Perform sensitivity testing prior to dose. See package insert.  CBC w/ platelets Hypersensitivity rxn,  Do not inject antivenin around the
Crotalidae envenomation envenomation  Give dose as soon as possible  PT anaphylaxis, serum sickness bite site. Never inject antivenin in a
polyvalent (rattlesnake,  PTT toe or finger.
(equine origin) copperhead, MILD – Local swelling, no MILD – 0 to 10 vials  Fibrinogen  Do not apply ice or tourniquets. Do
cottonmouth) systemic or lab abnormalities MODERATE – 10 to 20 vials  Fibrin degradation not attempt to incise fang marks.
MODERATE – Swelling  SEVERE - ≥ 20 vials products (FDP)  If the px is sensitive to horse serum
beyond bite site, ≥ 1 systemic  UA or other antivenin components,
manifestation, abnormal lab  See package insert for administration recommendations  H/H administration of diphenhydramine,
changes  BUN corticosteroids and epinephrine may
SEVERE – Marked local  Serum creatinine be required.
response, severe systemic effects,  Electrolytes  Update tetanus if needed.
significant lab abnormalities *Check q4h for at least
the first 12 hrs
Antivenin, North American  Mild, moderate or severe Initial dose:  CBC w/ platelets Mild hypersensitivity (urticarial,  Most effective if given within 6
crotalidae crotalid snake envenomation  4-6 vials IV over 1hr (25-50 mL/hr for the first 10 mins;  to 250 mL/hr if no  PT rash) rxn, especially in those hours of the bite.
polyvalent envenomation adverse response)  PTT allergic to papaya or papain  Do not apply ice or tourniquets. Do
immune fab (rattlesnake MILD – Local swelling, no  Repeat dose at 1hr intervals until control of sx is achieved.  Fibrinogen not attempt to incise fang mark.
(ovine origin), copperhead, systemic or lab abnormalities  UA  This product has much less risk of
(CroFab) cottonmouth) MODERATE – Swelling  Maintenance dose:  H/H hypersensitivity rxn than the horse
beyond bite site, ≥ 1 systemic  Once sx are controlled, give 2 vials q6h for 3 more doses. Additional doses of 2  Fibrin degradation serum based product.
manifestation, abnormal lab vials each may be administered as needed depending on px response. products (FDP)  Update tetanus if needed.
changes  Reconstitute vial w/ 10 mL SWFI. Further dilute in 250 mL NS and infuse over  BUN
SEVERE – Marked local 1hr.  Serum creatinine
response, severe systemic effects,  Electrolytes
significant lab abnormalities *Check q4h for at least
the first 12hrs
Antivenin, Black widow spider Severe or life threatening  Perform sensitivity testing prior to dose. See package insert.  Electrolytes Hypersensitivity rxn, Most beneficial when given w/in 4 hrs
Latrodectus envenomation. Also envenomations.  Calcium anaphylaxis, serum sickness of envenomation
mactans effective for other IV:  Glucose
(equine origin) species of  Dissolve 1 vial (2.5 mL) in 10-50 mL of D5W or NS and infuse over 15-30 mins.  CPK
Latrodectus  IV is preferred in cases of severe shock and in children <12 yrs old

IM:
 Inject the indiluted contents of 1 vial (2.5 mL) IM, preferably in the anterolateral
thigh
 A second vial may be considered if response w/in 1 hr is inadequate.
Antivenin, Eastern and Texas Positive identification of a coral  Perform sensitivity testing prior to dose. See package insert. Routine labs Hypersensitivity rxn,  Most beneficial when given w/in 4
Micrurus fulvius coral snake snake, or signs and symptoms of anaphylaxis, serum sickness hrs of envenomation
(equine origin) envenomation coral snake envenomation. Initial dose:  Do not apply ice or tourniquet or
 3-5 vials diluted in 250-500 mL of NaCl given by slow IV infusion attempt to incsise fang marks
 If the px is sensitive, administration
 Additional antivenin may be necessary. of diphenhydramine, corticosteroids
 See package insert for administration recommendations. and epinephrine may be required.
 Update tetanus if needed.
Atropine Organophosphate and For tx of cholinergic (SLUDGE) Adults: Initial dose of 1-2 mg IV Organophosphate Dryness of mucous membranes, For severe cases, may need
carbamate pesticides, symptoms due to drugs and Children: Initial dose of 0.05 mg/kg IV poisoning: tachycardia, mydriasis, continuous atropine infusion. Taper
muscarine containing
chemicals that inhibit  Individualize dose on the basis of response to initial dose. Repeat as necessary  Serum (or RBC) flushed/dry/hot skin, fever before discontinuation.
mushrooms,
acetylcholinesterase acetylcholinesterase activity q15-30 mins until signs of atropinization (i.e. flushing, drying of secretions, cholinesterase level (especially in children),
inhibitors (tacrine, mydriasis if pinpoint pupils are present). Large doses may be required. constipation, hallucinations and
donepezil) delirium ( in excess doses)

Florida, Ajie C. | 2019

 Calcium EDTA Lead For acute and chronic lead
poisoning and lead
encephalopathy
Charcoal, GI decontamination  For binding of a potentially toxic
activated substance in the GI tract
 Ineffective for alcohols,
hydrocarbons, metals and
inorganic minerals (i.e. Fe, Pb, Li,
As, Cyanide)
Cyanide Antidote Cyanide Tx of cyanide poisoning in
Kit significantly symptomatic parents.
(NaNO3, Na
thiosulfate, amyl
nitrate)
Deferoxamine Iron  Tx of acute iron toxicity (those
(Desferal) w/ s/sx of iron toxicity or serum Fe
level >350-500 mcg/dL
 Chronic Fe overload
Digoxin immune Digoxin, digitoxin  Tx of potentially life-threatening
fab digoxin intoxication (i.e. severe
(ovine origin) ventricular arrhythmias,
(Digibind) progressive bradyarrhythmias or
2nd or 3rd degree heart block not
responsive to atropine)
 Px has ingested >10 mg of
digoxin (Adults) or 4 mg (children)
 Serum conc. >10 ng/mL
 Serum K >5 mEq/L in this
setting
Dimercarpol As, Au, Hg and Pb  Tx of As, Au and acute Hg
(BAL in oil) poisoning (if started w/in 1-2 hrs)
 Tx of acute Pb poisoning of
levels ≥ 70 mcg/dL when used w/
Ca EDTA
 Not effective for chronic Hg
poisoning
Florida, Ajie C. | 2019
Adults:  Perform a UA daily Renal toxicity, pain at IM inj. site,  Ineffective for Pb levels <30-40
 1 g in 250-500 mL NS or dextrose 5% infused slowly over >1 hr (or give IM with  Renal fxn tests fever, chills, hypotension, mcg/dL
procaine) for 5 days  LFTs nausea, vomiting, anorexia,  Not recommended as sole agent for
 Interrupt therapy for 2 days  Urine output tremors, headache, tingling, levels ≥ 70 mcg/dL or in those w/ s/sx
 Repeat for 5 days if indicated numbness, mild  in LFTs, of enecephalopathy; use w/ BAL
Children: histamine-like rxn, Zn deficiency,  Perform abdominal radiograph to
 35-50 mg/kg/day IV slowly hypercalcemia, anemia, confirm absence of Pb in GI tract
 Dose is given q8-12 hrs transient bone marrow
 Give for 3-5 days depending on Pb level depression.
 Min. of 2 days need to elapse before considering a repeat course.
Adults: 25-100 g PO or NG None needed. Vomiting, diarrhea or  For pediatric administration, avoid
Children:1 g/kg PO or NG constipation adding a cathartic. May be mixed w/
Multiple Dose: soda.
 Use aq. charcoal only.  Most effective if given w/in 1 hr of
 Repeat the dose q4h ingestion
 Can be given in certain overdoses to enhance elimination (i.e. theophylline,  Do not use in pxs w/ CNS
phenobarbital, salicylates, carbamazepine, SR products) depression or at risk for seizures
w/out airway protection
See package insert.  Whole blood cyanide Methemoglobinemia, If signs of poisoning reappear, give
levels hypotension, headache, facial NaNO3 and Na thiosulfate at ½ the
 ABGs flushing, dizziness, nausea, orginal dose
 O2 sats vomiting, tachycardia, sweating
 electrolytes
 methemoglobin levels if
indicated.
 15 mg/kg/hr IV infusion (up to  Serum Fe Hypotension (more common w/  The normal serum Fe level = 50-
35-45 mg/kg/hr have been used for massive poisoning)  Glucose rapid infusion), rash, generalized 150 mcg/dL
 Max daily dose is 6 g (up to 16 g/day have been tolerated)  WBCs erythema, allergic-type rxn, inj.  The ferrioxamine chelate may
 May be given IM, but IV is preferred  Abdominal radiographs site rxn discolor the urine a pink to red-orange
(KUB – see comments) color (vin rose)
 CBC  Continue tx until s/sx resolve, the
 Electrolytes serum Fe level is < 150 mcg/dL and a
 BUN repeat KUB is (-) for the presence of
 Serum creatinine Fe in the GI tract
 LFTs  KUB is valuable to identify those at
risk for continued Fe absorption
 Perform sensitivity testing in high risk pxs prior to administration (i.e. those w/  Serum digoxin levels Allergic rxns (rare), low cardiac  Total serum digoxin may rise
known allergies or previously treated w/ Digibind) (obtain before output, CHF, hypokalemia, rapid precipitously following Fab
 Contact local poisoning control center or see package insert for dosing administration) ventricular response in pxs w/ administration. However, this will be
instructions.  Frequently check K atrial fibrillation almost entirely bound to the Fab
levels fragments and therefore not able to
 Serum Mg react w/ receptors in the body.
 Other electrolytes
 BUN
 Serum creatinine
 Give as deep IM inj  Renal fxn tests ADRs are dose related and  Avoid use in pxs allergic to peanut
Mild As or Au poisoning:  Urine pH (see include the ff: Pain at inj. site,  oil.
 2.5 mg/kg 4 times daily for 2 days, 2 times daily on the 3rd day, then once daily comments) BP, tachycardia, nausea,  Urinary alkalinization is
thereafter for 10 days vomiting, fever, headache, recommended because the BAL-
Severe As or Au poisoning: restlessness,  salivation, metal complex breaks down easily in
 3 mg/kg q4h for 2 days, 4 times daily on the 3 rd day, then twice daily thereafter nephrotoxicity, and convulsions an acid medium. Alkaline urine
for 10 days (rarely) protects protects the kidneys during
Hg poisoning: therapy.
 5 mg/kg initially, followed by 2.5 mg/kg 1-2 times/day for 10 days  Do not use for alkyl organic Hg
Acute Pb encephalopathy: poisoning as it may actually worsen
 4 mg/kg alone in the 1st dose and thereafter at 4hr intervals in combination w/ Ca nephrotoxicity.
EDTA administered at a separate site  Use w/ caution in oxs w/ G6PD
Less severe Pb poisoning: deficiency as hemolysis may occur.
 Dose can be  to 3 mg/kg after the initial dose. Maintain tx for 2-7 days
depending on clinical response.
 Ethanol Ethylene glycol  Any symptomatic px w/  Therapeutic blood alcohol level = 100 mg/dL  Stat blood alcohol level, Inebriation, CNS depression,  Continue tx until ethylene glycol or
methanol suspected ingestion of ethylene  Loading dose: 8-10 mL/kg of 10% ethanol (v/v) IV over 30 min then repeat q1-2 hrs until hypoglycemia (especially in methanol level is <20 mg/dL and the
glycol or methanol  Maintenance: Infusion of 0.8 mL/kg/hr for nondrinkers (2 mL/kg/hr for chronic steady state is reached children), respiratory depression px’s symptoms have resolved
 Ethylene glycol or methanol drinkers) of 10% ethanol (v/v). Begin maintenance dosing concurrent w/ loading q2-4 hrs including a normal serum pH
levels >20 mg/dL dose  Also serum ethylene  Fomepizole inhibits the elimination
 History or suspected ingestion of  Doses should be administered as an IV infusion of 10% ethanol (v/v) in D5W glycol and/or methanol of ethanol. Therefore, concomitant
toxic amounts and in whom blood  Adjust dose if px presents w/ an existing blood alcohol level or in those levels, serum glucose administration of ethanol w/
levels not readily available undergoing concomitant hemodialysis and electrolytes, ABGs, fomepizole is not recommended as
UA, serum osmolality (by toxic ethanol levels may result.
freezing point
depression), Ca, renal
fxn and anion gap
Flumazenil Benzodiazepines Complete or partial reversal of the Adults: Routine labs Dizziness, agitation, dry mouth,  Take caution when using flumazenil
(Romazicon) (BZD) effects of benzodiazepines  For BZD overdose, give 0.2 mg (2 mL) IV over 30 secs. If desired level of tremors, palpitations, insomnia, in a mixed drug overdose; toxic
consciousness is not obtained after waiting 30 secs, then give 0.3 mg (3 mL) over dyspnea, hyperventilation, effects (i.e., seizures, dysrhythmias)
another 30 secs. Further doses of 0.5 mg (5 mL) can be given over 30 secs at 1 emotional lability, confusion, of other drugs taken (especially
min intervals up to a cumulative dose of 3 mg. convulsions, cutaneous tricyclic antidepressants) may
 For resedation, give repeated doses q20 mins if needed. vasodilation, nausea, vomiting, emerge.
 For repeat tx, give ≤ 1 mg (given as 0.5 mg/min) at any one time and no more abnormal vision, headache, pain  Reversal of BZD may precipitate
than 3 mg in any hour. at inj. site,  sweating withdrawal in those dependent on
Children: 0.01 mg/kg over 1 min. Repeat doses of 0.01 mg/kg may be given at 1 them
min intervals up to 1 mg total dose.  Monitor for resedation
Fomepizole Ethylene glycol,  Any symptomatic px w/  Loading dose: 15 mg/kg  Monitor ethylene glycol Headache, nausea, dizziness,  Continue tx until ethylene glycol or
(Antizol) methanol suspected ingestion of ethylene  Maintenance dose: 10 mg/kg q12h for 4 doses, then 15 mg/kg q12h until levels and methanol levels. drowsiness, pain at inj. site, methanol level is <20 mg/dL and the
glycol or methanol is <20 mg/dL and the px is asymptomatic w/ normal pH  For ethylene glycol or hypotension,  or  HR, px is asymptomatic w/ a normal
 Ethylene glycol or methanol methanol poisoning, also diarrhea, agitation, drunk feeling, serum pH
levels >20 mg/dL Administration: monitor ABGs, UA, facial flush, anxiety  For concomitant tx w/ hemodialysis,
 History or suspected ingestion of  Dilute doses in ≥ 100 mL NS or 5% dextrose and infuse over 30 mins serum osmolality (by see package insert for dosing
toxic amounts and in whom blood  For concomitant tx w/ hemodialysis, see package insert for dosing instructions freezing point instructions.
levels not readily available depression), electrolytes,  Fomepizole inhibits the elimination
Ca, renal fxn and anion of ethanol. Therefore, concomitant
gap. administration of ethanol w/
fomepizole is not recommended as
toxic ethanol levels may result. A pre-
existing ethanol level level, however,
ddoes not preclude thee use of
fomepizole.
Glucagon B-blockers, possibly To aid in improving arterial Adults: 5-10 mg IV over 1 minute, followed by a 1-5 mg/hr IV infusion  Glucose Nausea, vomiting (especially w/  For continuous infusion, mix
Ca channel blockers pressure and contractility due to Children: 0.15 mg/kg IV over 1 min., followed by a 0.05-0.1 mg/kg/hr IV infusion K rapid infusion), hyper- or glucagon w/ normal saline or 5%
an overdose of a B-blocker hypoglycemia, hypokalemia, dextrose
 May also be given IM or SC, but IV route is preferred allergic rxn  Serum half life is only 8-18 mins.
Ipecac syrup GI decontamination To aid in GI decontamination of a Adults and adolescents:15-30 mL followed by 240 mL water None needed. Diarrhea, drowsiness, prolonged  Emesis usually begins w/in 20
potentially toxic substance in an Children (1-12 yrs old): 15 mL preceded or followed by 120-240 mL water. (> 1 hr) vomting mins.and may last for 20-30 mins
alert conscious person w/ an intact  Avoid giving w/ milk or carbonated
gag reflex  May repeat dose if emesis does not occur in 20-30 mins beverages
Methylene blue Methemoglobin- Symptomatic pxs w/  1-2 mg/kg IV over 3-5 mins  Methemoglobin levels Nausea, vomiting, diarrhea,  Blood sx w/ methemoglobin may
producing drugs or methemoglobinemia  Repeat dose if severely symptomatic px does not respond in 15 mins or if  ABGs bladder irritation, blue-green show chocolate colored blood when
poisons (initrates, moderately symptomatic px does not respond in 30-60 mins  H/H discoloration of urine and stool allowed to dry on filter paper
benzocaine,  O2 sats  Methylene blue is available as a 1%
phenazopyridine, solution
dapsone, aniline  Use w/ caution in pxs w/ G6PD
dyes) deficiency as hemolysis may occur
 Use w/ caution in treating aniline-
induced methemoglobinemia due to
risk of precipitating Heinz body
formation and hemolytic anemia.
Naloxone HCl Opioids Complete or partial reversal of Adults: Routine labs Nausea, vomiting, sweating,  If no response is seen after 10 mg
(Narcan) narcotic depression, including  0.4-2 mg IV. May repeat at 2-3 min intervals. Give 2 mg IV initially for pxs in tachycardia, HTN, has been given, question the
respiratory depression respiratory arrest and repeat every 2-5 mins (or as needed) up to 10 mg tremulousness diagnosis of narcotic-induced toxicity
 May be given IM or SC if IV route is not available  Reversal of opioid may precipitate
withdrawal in those dependent on
Continous IV infusion: them.
 Used for recurrent cardiorespiratory sx; give 0.4-0.8 mg/hr IV

Children: 0.01 mg/kg IV; Give subsequent dose of 0.1 mg/kg IV if needed
Florida, Ajie C. | 2019
 Octreolide Oral Sulfonylureas Hypoglycemia due to oral Adults: 50-100 mcg SC q6-12 hrs as needed until hypoglycemia resolves Serum glucose Flushing, edema, fatigue, Use in combination w/ dextrose.
(Sandosiatin) sulfonylurea ingestion Children: No pediatric dose available w/ this indication headache, dizziness, nausea,
vomiting, diarrhea, abdominal
pain, pain at inj. site, weakness
Phentolamine Extravasation of Extravasation of vasoconstrictive Adults: 5-10 mg Routine labs Weakness, dizziness,  Most effective if given w/in 12 hrs
(Regitine) vasoconstrictive agents (epinephrine) Children: 0.1-0.2 mg/kg (max of 10 mg) tachycardia, hypotension from the time of extravasation.
agents  May be ineffective if given > 24 hrs
 Dilute dose in 10-15 mL of NS. Infiltrate the extravasated area until the entire after.
site is infiltrated, including approx. 0.5 inches around the periphery.
Physostigmine Anticholinergic Reversal of severe effects Adults: 0.5-2 mg slowly IV (≤ 1 mg/min). May be repeated q10 mins until Routine labs Seizures, cholinergic crisis,  Use very cautiously
agents (pronounced hallucinations and resolution of life threatening symptoms. bradyarrhythmias, asystole,  Use only when px has central and
agitation, intractable seizures) Children: nausea, vomiting, salivation peripheral anticholinergic sx.
caused by anticholinergic agents.  0.02 mg/kg slowly IV (≤ 0.5 mg/min.). May repeat at 5-10 min intervas until  Must be given slowly IV (over 5-10
Not to be used for tricyclic therapeutic effect or max dose of 2 mg is attained mins)
antidepressant poisoning.
 May be given IM
Phytonadione Coumarin and Excessive anticoagulation induced Adults:  PT Flusing, dizziness, altered taste  Give IV only when other routes are
(Vit K1) idanedione by coumarin (warfarin) or  SC: 5-10 mg; may be repeated in 6-8 hrs if needed  PTT sensations, rapid and weak not feasible and the serious risk
indanedione derivatives  PO: 10-25 mg/day  INR pulse, profuse sweating, involved considered justified. (Max
 IV: 10-50 mg (see comments) hypotension, dyspnea, cyanosis, infusion is 0.5-1 mg/min)
Children: pain at inj. site, anaphylactoid  Onset of action is 1-2 hrs
 SC: 1-5 mg; may be repeated in 6-8 hrs if needed rxn, IV administration has  Not effective for anticoagulant
 PO: 5-10 mg/day caused ventricular fibrillation and action heparin.
 IV: 0.6 mg/kg (see comments) death.

 SC is preferred route. Avoid IM

 Switch to PO for maintenance therapy
Polyethylene GI decontamination Whole bowel irrigation to enhance Adults and adolescents: 1500 -2000 mL/hr Routine labs Nausea, vomiting, bloating,  Best administered through NG tube
glycol electrolyte elimination of potentially toxic Children (6-12 yrs. old): 1000 mL/hr abdominal cramps  Ensure airway is intact or protected.
solution ingestions (SR or enteric coated Children (9 mon-6 yrs old): 500 mL/hr
(GoLYTELY) drugs, Fe, Li, packets of illicit
drugs)  Continue until rectal ffluent is clear or longer if presence of toxin is still evident in
the GI tract.
Pralidoxime Organophosphate Tx of severe organophosphate Adults: 1-2 g IV Serum or RBC Dizziness, blurred vision,  Efficacy is time dependent; best if
(2-PAM) pesticides poisoning (muscle weakness, Children: 25-50 mg/kg IV cholinesterase level diplopia, headache, drowsiness, given in the first 24-48 hrs after
(Protopam) respiratory depression) in  Give as 15-30 min infusion in 100 mL of normal saline nausea, tachycardia, HTN, exposure.
conjunction w/ atropine.  May give a second dose after 1hr if muscle weakness is not relieved hyperventilation, muscle  Atropine should be given
Maintenance infusion: weakness concurrently
 Adults: 200-500 mg/hr
 Children: 5-20 mg/kg/hr
Protamine Heparin Reversal of anticoagulant effect of  1 mg of protamine neutralizes ≈ 90 units of heparin aPTT Hypotension, bradycardia,  Half life of protamine is shorter than
sulfate heparin overdose.  Give slowly IV over 10 mins flushing, dyspnea, nausea, heparin’s, so recurrent bleeding may
 Immediately after heparin administration: Give 1-1.5 mg protamine per 100 vomiting, hypersensitivity occur
units of heparin (up to 50 mg)
 30-60 mins after heparin: Give 0.5-0.75 mg protamine per 100 units of heparin
 2 or more hrs after heparin: 0.25-50 mg protamine
 Guide dosage by coagulation studies
Pyridoxine HCl Isoniazid (INH) and Tx of symptomatic pxs from INH  Give IV over 5 mins Routine labs Sensory neuropathy, unstable  Gyromitra sp. Are also known as
(Vit B6) monomethylhydrazi overdose or ingestion of Gyromitra gait, paresthesia, photoallergic false morels.
ne (Gyromitra mushrooms For INH: rxn
mushrooms)  Dose should be equal (mg to mg) the ingested amount of INH
 When amount of INH is not known, giveL
Adults: 5 g
Children: 75 mg/kg

For Gyromitra mushrooms:

 Give 20-30 mg/kg or 5 g IV if pt is having a seizure; repeat for recurrent
seizures; or if pt is comatose.
Succimer, DMSA Pb, As, Hg  Tx of Pb poisoning in those w/  First 5 days: 10 mg/kg (or 350 mg/m2) PO TID  Serum Pb level at least Nausea, vomiting, diarrhea, loss  Pb levels may rebound 2-4 weeks
(Chemet) levels ≥ 45 mcg/dL.  Next 14 days: 10 mg/kg (or 350 mg/m2) PO BID once weekly until stable of appetite, metallic taste in after cessation of therapy
 Also shown to be effective of As  LFTs mouth,  serum tranaminases,  Repeat tx as indicated, w/ a week
and Hg poisoning.  WBC rash interval between txs.
ANTIDOTE CHART

Florida, Ajie C. | 2019

Florida, Ajie C. | 2019