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Antidote

For other uses, seeAntidote (disambiguation).
Not to be confused withanecdote.

Anantidote is a substance that can counteract a form ofpoisoning.[1] The term ultimately derives from the Greek term φάρμακον ἀντίδοτον(pharmakon antidoton), "(medicine) given as a remedy". An older term in English which is now rare isatterlothe, derived from "atter" ("poison" or "venom").[2] Antidotes for anticoagulants are sometimes referred to asreversal agents.[3]

The antidotes for some particulartoxins are manufactured by injecting the toxin into an animal in small doses and extracting the resultingantibodies from the host animals' blood. This results in anantivenom that can be used to counteractvenom produced by certain species ofsnakes,spiders, and other venomous animals. Some animal venoms, especially those produced byarthropods (such as certainspiders,scorpions, andbees) are only potentially lethal when they provoke allergic reactions and induceanaphylactic shock; as such, there is no "antidote" for these venoms; however anaphylactic shock can be treated (e.g. withepinephrine).

Some other toxins have no known antidote. For example, the poisonbatrachotoxin – a highly poisonoussteroidal alkaloid derived from variouspoison dart frogs, certain beetles, and birds – has no antidote, and as a result, is often fatal if it enters the human body in sufficient quantities.

Mechanical approaches

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Ingested poisons are frequently treated by the oral administration ofactivated charcoal, whichadsorbs 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 the circulation of the poison around the body.[4] This should not be confused with the use of atourniquet which cuts off blood flow completely – often leading to the loss of the limb.

Techniques to identify antidotes

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In early 2019, a group of researchers in Australia published the finding of a newbox jellyfish venom antidote usingCRISPR.[5] The technology had been used to functionally inactivate genes in human cell lines and identify the peripheral membrane proteinATP2B1, a calcium transporting ATPase, as one host factor required for box jellyfish venomcytotoxicity.[6]

List of antidotes

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AgentIndication
Activated charcoal withsorbitolUsed for many oral toxins
Theophylline orCaffeineAdenosine receptoragonist poisoning
Antimuscarinic drugs (e.g.Atropine)Organophosphate andcarbamate insecticides,nerve agents, somepoison mushrooms
Beta blockerTheophylline
Calcium chloride[7]Calcium channel blocker toxicity,[7]black widow spider bites
Calcium gluconate[7]Calcium channel blocker toxicity,[7]hydrofluoric acid burns
Chelators such asEDTA,dimercaprol (BAL),penicillamine, and 2,3-dimercaptosuccinic acid (DMSA, succimer)Heavy metal poisoning
Cyanide antidotes (hydroxocobalamin,amyl nitrite,sodium nitrite, orthiosulfate)Cyanide poisoning
CyproheptadineSerotonin syndrome
Deferoxamine mesylateIron poisoning
Digoxin Immune Fab antibody (Digibind and Digifab)Digoxin poisoning,Oleander ingestion[8]
Diphenhydramine hydrochloride andbenztropine mesylateExtrapyramidal reactions associated withantipsychotics
100%Ethanol orfomepizoleEthylene glycol poisoning andmethanol poisoning
FlumazenilBenzodiazepine overdose
100%oxygen orhyperbaric oxygen therapy (HBOT)Carbon monoxide poisoning andcyanide poisoning
IdarucizumabReversal ofdabigatran etexilate, ananticoagulant
Insulin +GlucagonBeta blocker poisoning and calcium channel blocker poisoning
LeucovorinMethotrexate,trimethoprim andpyrimethamine overdose
IntralipidLocal Anesthetic toxicity
Methylene blueTreatment of conditions that causemethemoglobinemia
Naloxone hydrochlorideOpioid overdose
N-acetylcysteineParacetamol (acetaminophen) poisoning
OctreotideOralhypoglycemic agents
Pralidoxime chloride (2-PAM)When given with Atropine:Organophosphate insecticides,nerve agents, somepoison mushrooms
Protamine sulfateHeparin poisoning
Prussian blueThallium poisoning
Physostigmine sulfateAnticholinergic poisoning
PyridoxineIsoniazid poisoning, ethylene glycol, accidental hydrazine exposure (E.G fromGyromitra mushrooms)
Phytomenadione (vitamin K) andfresh frozen plasmaWarfarin overdose and some (but not all) rodenticides
Sodium bicarbonateAspirin,TCAs with a wide QRS[clarification needed]
I.VSilibininAmatoxin ingestion
Succimer, chemical name Dimercaptosuccinic acid (DMSA)Lead poisoning

See also

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Look upantidote in Wiktionary, the free dictionary.

References

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  1. ^"antidote" atDorland's Medical Dictionary.
  2. ^"atterlothe".OED. Retrieved27 December 2024.
  3. ^Christos S, Naples R (2016)."Anticoagulation Reversal and Treatment Strategies in Major Bleeding: Update 2016".West J Emerg Med.17 (3):264–70.doi:10.5811/westjem.2016.3.29294.PMC 4899056.PMID 27330657.
  4. ^Smith, T. A.; Figge, H. L. (October 1991)."Treatment of snakebite poisoning".American Journal of Hospital Pharmacy.48 (10):2190–2196.ISSN 0002-9289.PMID 1781479.
  5. ^The-Crispr (2019-05-13)."Antidote to deadly jellyfish identified using CRISPR".The Crispr. Retrieved2019-08-08.
  6. ^Neely, G. Gregory; Seymour, Jamie E.; Hesselson, Daniel; Nguyen, David T.; Qiao-Ping Wang; Khuong, Thang M.; Oyston, Lisa; Littleboy, Jamie B.; Manion, John (2019-04-30)."Molecular dissection of box jellyfish venom cytotoxicity highlights an effective venom antidote".Nature Communications.10 (1): 1655.Bibcode:2019NatCo..10.1655L.doi:10.1038/s41467-019-09681-1.ISSN 2041-1723.PMC 6491561.PMID 31040274.
  7. ^abcd"Calcium channel blocker poisoning".UpToDate. Retrieved2019-07-09.
  8. ^"Naturally Occurring Cardiac Glycoside Poisoning · California Poison Control System (CPCS)".

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