Methadone Symptoms

Question by Ash: antidotes for drugs?
ok, im in nursing school and i have a tone of drugs i have been looking up and im having trouble finding antidotes or antagonist! the only ones that are shown in my drug book are the drugs that provide an analgesic opiod reaction and they are antagonized by Narcan. if any of you out there can give me a web site or something i would so appreciate it! thanks for your help!

Best answer:

Answer by Crazy Mermaid
Hmm, this sounds like a complicated question… Maybe try searching around on the American Pharmacists Association website?

http://www.pharmacist.com/AM/Template.cfm?Section=Drug_Information&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=88&ContentID=11339

Answer by AJ
Yup, this is a complicated question. Perhaps you can tell me which drugs you have and I can give you the antagonist or antidote. Narcan is primarily a full opioid antagonist at all three opioid receptors. However, some benzodiazepines have activity at the opioid receptors too, in addition to enhancing the activity of endogenous opioids. So Narcan is listed as an antagonist to use in benzodiazpine overdose. This isn’t technically correct since the benzodiazepine antagonist is Flumazenil (Anexate). Other common examples of antagonists or antidotes are:
Atropine for Muscarine poisoning
Physostigmine for Atropine/Scopolamine poisoning.
etc.

EDIT: Right….few issues…..there are a number of drugs for which no specific antidote exists in the event of overdose. Supportive treatment is given. For example, start with the antihistamines. There is no specific antidote for antihistamines. Symptomatic treatment given (ie. gastric lavage, administration of charcoal and a cathartic). Tonic-clonic seizures can occur. These can be treated with anti-convulsants. Recurrent seizures treated by PHENYTOIN. Now if excess anti-cholinergic activity is taking place, that can be reversed with the Atropine antidote, PHYSOSTIGMINE. There are other issues that can surface (myocardial depression, QRS interval prolongation). Supportive treatment given for that too.

Here is a general list:
Overdose – “antidote”/antagonist
* Anticholinergic poisoning – physostigmine
* Atropine poisoning – Anticholinesterase and pralidoxime chloride (2-PAM)
* Benzodiazepine overdose – flumazenil
* Beta blocker poisoning – glucagon
* Carbon monoxide poisoning – oxygen
* Cyanide poisoning – 4-Dimethylaminophenol followed up with sodium thiosulphate or cobalamin
* Digoxin poisoning – Fragment antigen binding(Fab) fragments that bind to digoxin (trade names Digibind and Digifab)
* Ethylene glycol poisoning – ethanol or fomepizole
* Extrapyramidal reactions associated with antipsychotic poisoning – diphenhydramine hydrochloride and benztropine (Trihexyphenidyl can be used in place of benztropine)
* Heavy metal poisoning – chelators, calcium disodium edetate (EDTA), dimercaprol (BAL), penicillamine, and 2,3-dimercaptosuccinic acid (DMSA, succimer)
* Heparin poisoning – protamine
* Iron poisoning – deferoxamine
* Isoniazid poisoning – pyridoxine
* Methanol poisoning – ethanol or fomepizole
* Methemoglobinemia poisoning – methylene blue
* Opioid poisoning – naloxone (NARCAN) / for longer acting opioids like Methadone, it may be best to use a longer acting antagonist like Nalmefene
* Paracetamol (acetaminophen) poisoning – N-acetylcysteine
* Thallium poisoning – Prussian blue
* Warfarin poisoning – vitamin K, phytonadione and fresh frozen plasma
* In cases of neuroleptic malignant syndrome, the use of dantrolene and dopamine agonists (amantadine and bromocriptine) has been described

Now for that list you gave me, I would like to point out that in Phenergan’s case, it is an antihistamine yes, but it is also a phenothiazine with antipsychotic activity (albeit much lower than say chlorpromazine). Extra-pyramidal symptoms may occur in overdose. So follow the entry above for extra-pyramidal symptoms for anti-psychotics.

For Pitocin and Methergine, no specific antidotes exist.

For Dantrolene as an antidote, use is indicated in:
a) the treatment of malignant hyperthermia induced in susceptible individuals by anaesthetic agents or skeletal muscle relaxants;

b) the treatment of malignant neuroleptic syndrome;

c) the treatment of hyperpyrexia due to poisoning with Strychnine, Cicuta species (water hemlock) or Phencyclidine (PCP), and perhaps also hyperpyrexia due to poisoning with amphetamines, cocaine, lysergic acid diethylamide (LSD), theophylline or monoamine-oxidase inhibitors (MAOIs).

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