ANTIDOTE

BY
SUBEESH KUMAR P(102)
Antidote - Definition

 An antidote is defined as a remedy to

counteract or neutralize the effects of a
poison.

 In various poisonings, antidotes are used to

counteract the pathophysiology produced
by a toxin.
Antidote - Classification

 Mechanical or Physical antidotes

 Chemical antidotes

 Physiological antidotes
Mechanical or Physical antidotes
These antidotes counteract the effect of poison
mechanically

preventing their absorption

without inactivating the damaging action of the

poisons.
Mechanical or Physical antidotes

 Activated charcoal

 Demulcents

 Bulky foods

 Diluents
 Universal Antidote

 During the last decade or so, it has been

increasingly recognized that the formulation
known as "universal antidote" (2 parts
activated charcoal, 1 part tannic acid,
and 1 part magnesium oxide)

 is generally less effective than activated

charcoal alone as an oral antidote.
Mechanical or Physical antidotes
Demulcents
 Demulcents produce protective coating over the
mucous membrane of stomach to protect it from
the action of poison.

 These are milk, egg white, starch, milk of magnesia

and aluminium hydroxide gel.
Mechanical or Physical antidotes
Bulky foods
 Bulky foods like Bananas, boiled rice or potatoes
admixed with the poison and decreases its
absorption.

 The bulky foods are commonly used in ingestion of

glass powder as these particles are embedded in
them and prevent damage to the stomach mucosa.
Mechanical or Physical antidotes
Diluents

 Diluents such as water, milk or other similar drinks

that dilute the poison and delay their absorption
Chemical antidotes

The chemical antidotes disintegrate and inactivate

poisons by undergoing chemical reactions along

with the poisons and forming harmless or insoluble

compounds.
Chemical antidotes

 Weak non-carbonate alkalis

 Weak vegetable acids
 Albumen
 Copper sulphate
 Potassium permanganate
 Tincture iodine or Lugol’s iodine
 Tannic acid
Chemical antidotes
Weak non-carbonate alkalis Corrosive acid poisoning

Weak vegetable acids Corrosive alkali poisoning

Albumen Mercury poisoning

Copper sulphate Phosphorous poisoning

Potassium permanganate cyanides, phosphorus,

atropine
Tincture iodine or Lugol’s lead, mercury, silver, alkaloids
iodine and strychnine

Tannic acid lead, mercury, nickel,

zinc, copper, aluminium, cobalt
and silver; strychnine, nicotine,
cocaine
Physiological antidotes

 These antidotes acts on the tissues or organs and

antagonizes the actions of a poison.

 Indicated in the condition, where poison have

already been absorbed into the circulation.

 Ex: Atropine for organophosphorus compounds

 barbiturate for strychnine

Antidote - MOA

1. Inert complex formation

2. Accelerated detoxification
3. Reduced toxic conversion
4. Receptor site competition
5. Receptor site blockade
6. Toxic effect bypass
Antidote - MOA

1. Inert complex formation:

 Some antidotes interact with the poison to form an

inert complex which is then excreted from the body,
 e.g.

 chelating agents for heavy metals

 Prussian Blue for thallium
 specific antibody fraggjgments for digoxin
 dicobalt edetate for cyanide
Antidote - MOA

2. Accelerated detoxification

Some antidotes accelerate the detoxification of a

poison.
e.g.
 thiosulfate accelerates the conversion of cyanide to
nontoxic thiocyanate

acetylcysteine acts as a glutathione substitute which

combines with hepatotoxic paracetamol metabolites
and detoxifies them.
Antidote - MOA

3. Receptor site competition

 Some antidotes displace the poison from

specific receptor sites, thereby antagonising
the effects completely.
 Ex: Naloxone for opioid poisoning at opioid
receptors
Antidote - MOA

4. Reduced toxic conversion

Some poisons are toxic and some poisons after

metabolism, their metabolites are toxic. In such
poisoning, the antidotes competes for metabolic
enzymes and inhibits the metabolism of the
poison, thereby decreasing the toxic effect
Ex: Ethanol for methanol toxicity for aldehyde
dehydrogenase enzyme
Antidote - MOA

5. Receptor site blockade

Antidotes blocks the receptor site of the

poisons.
Ex: Atropine blocks muscarinic receptor site for
organophosphorous poisoning.
Antidote - MOA

6. Toxic effect bypass

 An example of this type of antidotal action is

provided by the use of 100% oxygen in
cyanide poisoning.
Antidote – Clinical applications
Antidote – Clinical applications