Antidotes for some common Chemicals

Antidotes for some common Chemicals:

Antidotes are therapeutic agents used to counteract the toxic effects of specific xenobiotics. These are heterogenous group of substances consisting of pharmaceuticals, biological agents and immunoglobulin fragments. Different mechanisms of action are involved Some specifically act at the receptor sites while others exert their effect by changing the metabolism of the poison counteracting the toxic injury or just forming the inert complex with the poison. Antidotes acting at receptor sites: Drug intoxications are mostly treated with these antidotes.
However, Atropine is a specific antidote for organophosphate or carbamate pesticide poisoning. Similarly physostigmine for Dhatura and neostigmine for Curare poisonings are useful. Others include, naloxone for opioid, flumazenil for benzodiazepines and physostigmine for atropine poisoning.

In general, antidotes should be given in adequate doses as early as possible in cases of poisoning. Some antidotes cause serious adverse reactions. Hence, both the risk and the benefits of the antidotal therapy must, therefore, be carefully evaluated and the patient must be monitored regularly. At times the half-life of some antidotes like naloxone, atropine is much shorter than the toxin, in which cases the antidotal therapy must be continued till the symptoms of the poisoning subside.

Sr.No	Chemical	Antidote / Medical Treatment
1	Acids and Sulphur Oxides (SOx), or Alkalis	Wash with plenty of water if eyes or skin is affected. Do not give chemical antidote because it increases heat and injury with reaction. Do not induce vomiting. Milk, lemon water or milk of magnesia can be given.
2	Acetonitryl, Acrylonitryl, Lactronitryl, Cyanogen chloride or bromide	Very careful treatment of cobalt E.D.T.A. (calocynor) and if that is not effective give nitrite/thio sulphate treatment .
3	Alkali phosphates and Ammonia	Immediately give water or milk and induce vomiting. For the hypocalcimic effect of phosphate give 5 ml intravenous injection of 10% calcium gluconate. If eye or skin is affected wash with plenty of water for 15 min.
4	Ammonia	If skin is affected then wash with plenty of water for 15 min. and then wash with dilute lactic acid and apply soframycin cream. If eye is affected then wash by eye fountain with plenty of water for 15 min. Put one drop of 0.4% Benzocaine (Novocaine) solution in eye. Boric or lactic acid solution eye drops can also be given, If entered in throat then give smell through cotton dipped in ethanol or ether through nose. Administer oxygen in case of breathing difficulty.
5	Aniline, Toludine and Nitrobenzene	Methylene-Blue (1% solution). Ascorbic acid (5% solution) Administer oxygen in case of breathing difficulty.
6	Anticoagulants (Heparin) etc.	Protamin sulphate (1% solution), Vitamin-K (1% solution).
7	Antimony and Stibine	Dymer caprol (BAL) .
8	Arsenic	BAL (British Anti Lewistic compound) ie Dimer caprol, penicillamine. Induce vomiting.
9	Arsine (Hydrogen arsenide)	Mercaptide (40% solution, Dimercaptopropanol, penicillamine).
10	Atropine	Pilocarpine (1% solution). Proserin (0.05% solution).
11	Barium and its salt	Magnesium sulphate (30 gm in 250 ml water). Morphine (5 to 10 mg.) .
12	Barbiturates	Barmegride (0.5 % solution).
13	Benzene, Toluene & Xylene	Skin is affected then wash with plenty of water. Administer Oxygen or shift to fresh air.Diazepam 0.1 mg / kg. (iv), bed rest.
14	Beryllium	Calcium edentate, Prednisolone.
15	Bis-chloro methyl ether	N-acetyl-L-cysteine.
16	Bleaching solution	Milk, melted ice-cream, eggs, milk of magnesia, aluminium hydroxide gel. Do not give acid antidotes.
17	Bromides	Skin is affected then wash with plenty of water. Give 1 gm. Salt in water by mouth. If this is not possible then intravenous (iv) injection of normal saline. Give milk and water.
18	Boric acid and Boron derivatives	Ipecac solution and activated charcoal. Infra muscular (im) injection of 5% dextrose if nausea.
19	Cadmium	Calcium disodium edetate i.e. CaNa2EDTA by intravenous or muscle.
20	Carbon monoxide	Administer Oxygen (100% pure), intravenous injection of 1 gm/kg of 20%mannitol, or 1 mg./ kg of Prednisolone.
21	Carbon tetrachloride or Chloroform	N- acetyl -L- cysteine.
22	Carbonyls	Tablets of Sodium diethyl dithio carbamate, 2 tablets immediately and then 1 tablet every two days for next two days. Administer Oxygen in case of breathing difficulty.
23	Cardiac Glycosides	Potassium chloride (0.5% solution). Atropine sulphate (0.1% solution), Tefacin calcium (10% solution).
24	Chlorine, Bromine, Phosgene	Skin is affected then wash with plenty of water. Apply Sodium bicarbonate and again wash with water. Eye is affected then flush eye in eye fountain. Put 2-3 drops in eye of Pontocaine 0.5% solution ot Benzocaine (Novocain) 0.4% solution. If inhaled then give smell through ethanol or ether dipped cotton. ; Give milk, buttermilk or lemon water. Give 02 in case of breathing difficulty.
25	Chlorates	Ipecac solution, activated charcoal, milk. Don't give Methylene blue. Add 2 to 5 gms. Sodium thiosulphate in 200 ml of 5% Sodium bicarbonate solution and give by mouth.
26	Cosmetics (Bromates)	Intravenous injection of 1 ml./kg Sodium thiosulphate (10% solution) .
27	Chromium	Dimercaprol.Give high vitamins, protein and carbohydrates in food. Methylene blue.
28	Cyanides and Thiocyanate insecticides	Methylene blue or Calocyanides injection. If inhaled gives smell of amyl nitrate ampule (0.2 ml) every 5 minutes. Intravenous injection of Sodium nitrite (3% solution) and Sodium thiosulphate (25% solution) but if blood pressure decreases, then stop it. 4 DMAP (Dimethyl amino phenol) 3 mg/kg, iv, along with thiosulphate. Hydroxocobalamine, 4 gm,iv, in 5% dextrose. Dicobalt edetate, 300 - 600 mp-, iv, over l-5min.
29	DDT (Halogenated insecticides)	Ipecac syrup, activated charcoal. Saline cathartic, Diazepam (10 mg.) by intravenous injection, wash skin with soap and water. In case of breathing difficulty administer Oxygen.
30	. Dichlorophenoxy acetic acid insecticides	Ipecac syrup, activated charcoal. Saline cathartic, Lidocane (50-100 mg by intravenous injection).
31	Dimethyl sulphate	Skin is affected then apply Magnesium oxide paste and give injection of Corticosteroid. In case of breathing difficulty administer Oxygen.
32	Dichloro methane	Hydro cortisone (200 mg every 4 hours). In case of aspiration pneumonia give antibiotics.
33	Dinitrophenol or Cresols	5% Glucose saline by intravenous injection.
34	Ethanol	2 gm. Of Sodium bicarbonate in 250 ml water, Diazepam 10 mg., by intravenous. Skin or eye is affected then wash with plenty of water.
35	Ethylene or Diethylene glycol	Ethanol, Calcium gluconate Pyridoxine .
36	Fluorine, Hydrogen fluoride and derivatives.	Intravenous injection of 10 ml. Calcium gluconate (10% solution). If serum magnesium level is low then give 10 ml Milk of magnesia every hour. Give more milk and liquids. If eye is affected then wash with plenty of water.
37	Formaldehyde	Milk, activated charcoal or water.
38	Formalin	Ammonium chloride or Ammonium carbonate (3% solution).
39	Hydrogen sulphide, other sulphides and Mercaptans	Shift in fresh air or administer Oxygen. Give inhalation of ethanol or ether drops. Amyl nitrite or Sodium nitrite, Pyridoxine 20 mg./kg. or 10% urea 1 gm./kg by intravenous injection.
40	Hydrogen cyanide	Give inhalation of 0.2 ml amyl nitrite dipped cotton. Sodium nitrite (1% solution). Sodium thiosulphate (30% solution), Cromosmon (1% methylene blue in 25 % glucose solution).
41	Iodine and compositions	Milk, Fine starch solution, 100 ml of 1% Sodium gluconate 10% solution.
42	Iron salts	Careful treatment of deferroxamine therapy.
43	Lead compounds	CaNa2 EDTA, D-Penicilliamine (oral), BAL (with CaEDTA), Induce vomiting, then give Magnesium sulphate in water.
44	Magnesium salts	Intravenous injection of 1 ml/ kg of Calcium gluconate 10% solution.
45	Manganese	Calcium edentate.
46	Mercury as Hg, Alkyl or Aryl compounds	Give white of egg in water. Later give milk, Then induce vomiting. BAL, D-Pencilliamine, n- Acetylcysteine, Dimercaptopropane- 1 sulfonate DMPS).
47	Metals (Heavy metals, mercury, lead, copper, cobalt, arsenic, nickel)	Unithol (BAL, dimercaprol, 5% solution), Tetacin calcium (10% solution), Penicillamine Dextrose (10%) by intravenous injection. Chillating agent for effect of mercury.
48	Metal Compounds (Heavy metals compositions)	Activated carbon (carbolin) BAL .
49	Methanol	Ethanol (30% solution from inside, 5% solution from outside i.e. by intravenous injection), Epicake Syrup. In case of acidosis give Sodium bicarbonate. In case of delirium give Diazepam 10 mg. by intravenous injection. Folinic acid (Leucovorin), 1 mg/kg, iv, 4 hourly.
50	Metaldehyde	D-Penicillamine, Ascorbic acid or Thiamine to be given carefully.
51	Naphthalene 5 gm.	Sodium bicarbonate every 4 hrs. and keep urine alkaline. Give 1 ml/kg, furosemide in liquid. Blood transfusion till haemoglobin becomes normal -60 to 80%.
52	Nitrates, Nitrites, Nitrobennzene Sulfonamides Dapsone	Methylene blue, 1-2 mg / kg, iv, over 5 min.
53	Nitrogen oxides (NOx)	Prednison or prednisolone 5 mg. every 6 hrs. interval.
54	Orgnaic phosphate or carbamate insecticides (abet, dizionon, dimate, EPN, Ethyl Phosphamidon, Phosvel, Selithion, Aldecarb, Baygon, Sevin etc.)	Ipecac syrup, Atropine sulphate 2 mg. by intravenous injection every 3-8 mins interval. Prelidoxim by intravenous. Obidoxim (Toxogonin), skin to be washed with soap and water.
55	Orgao phosphorous insecticides (e.g. Malathion, Parathion, Monocrotophos, Phorate)	Atropine injection, atropine sulphate (0.1% solution), Nalorphine hydrochloride (0.5% solution), Trimedoxim bromide (15% solution), Pyridine Aldoxy Methyodate, Diperoxim, Biodexim and Isonitrocin (40% solution), Pralidoxim, RAM, TOXOGONIN.
56	Oxalic acid	Milk, lemon water, chalk or calcium lactate, calcium chloride or calcium gluconate with liquid. 10% calcium gluconate or chloride 10 ml. by intravenous injection.
57	p-Nitro Chlorobenzene (PNCB)	Methylene blue .
58	Phenol & Derivatives	Shift in fresh air, activated charcoal and 240 ml. milk. If skin or eye is affected then wash with plenty of water for 15 min. If skin is affected then wash with Polyethylene glycol(PEG).
59	Phosgene	Cortisone acetate 1 mg./kg by mouth - thrice a day. In case of breathing difficulty administer Oxygen.
60	Phosphorous, Phosphine & Phosphides	10 ml. Calcium gluconate (10%) by intravenous injection, 5% glucose in water. Travert (10% invert sugar) by intravenous injection.
61	Potassium permanganate	Hot milk, Methylene blue (1% solution) Ascorbic acid (5% solution).
62	Silica & Asbestos dust	Reduce dust level by local exhaust ventilation. Use airline respirator.
63	Silver nitrate & other salts 10%	Salt (Sodium chloride) solution, milk and for reducing, pain Demrol or Codeine.
64	Tobacco & Nicotine	Induce vomiting, Atropine (large dose).In case of difficulty in breathing, administer Oxygen.
65	Vinyl chloride	Skin is affected, wash with plenty of water. Eye is affected then keep eye open and allow material to vaporise. Don't apply any eye drops In case of breathing difficulty, administer Oxygen. If injected then induce vomiting. Give one spoon mineral oil and after that give sodium/magnesium sulphate (one spoon) in a glass of water. Give strong tea or coffee if feeling exhausted.

Sr.No

Chemical

Antidote / Medical Treatment

Acids and Sulphur Oxides (SOx), or Alkalis

Wash with plenty of water if eyes or skin is affected.
Do not give chemical antidote because it increases heat and injury with reaction. Do not induce vomiting.
Milk, lemon water or milk of magnesia can be given.

Acetonitryl, Acrylonitryl, Lactronitryl, Cyanogen chloride or bromide

Very careful treatment of cobalt E.D.T.A. (calocynor) and if that is not effective give nitrite/thio sulphate treatment .

Alkali phosphates and Ammonia

Immediately give water or milk and induce vomiting. For the hypocalcimic effect of phosphate give 5 ml intravenous injection of 10% calcium gluconate. If eye or skin is affected wash with plenty of water for 15 min.

Ammonia

If skin is affected then wash with plenty of water for 15 min. and then wash with dilute lactic acid and apply soframycin cream. If eye is affected then wash by eye fountain with plenty of water for 15 min. Put one drop of 0.4% Benzocaine (Novocaine) solution in eye. Boric or lactic acid solution eye drops can also be given, If entered in throat then give smell through cotton dipped in ethanol or ether through nose. Administer oxygen in case of breathing difficulty.

Aniline, Toludine and Nitrobenzene

Methylene-Blue (1% solution). Ascorbic acid (5% solution) Administer oxygen in case of breathing difficulty.

Anticoagulants (Heparin) etc.

Protamin sulphate (1% solution), Vitamin-K (1% solution).

Antimony and Stibine

Dymer caprol (BAL) .

Arsenic

BAL (British Anti Lewistic compound) ie Dimer caprol, penicillamine. Induce vomiting.

Arsine (Hydrogen arsenide)

Mercaptide (40% solution, Dimercaptopropanol, penicillamine).

Atropine

Pilocarpine (1% solution). Proserin (0.05% solution).

Barium and its salt

Magnesium sulphate (30 gm in 250 ml water). Morphine (5 to 10 mg.) .

Barbiturates

Barmegride (0.5 % solution).

Benzene, Toluene & Xylene

Skin is affected then wash with plenty of water. Administer Oxygen or shift to fresh air.Diazepam 0.1 mg / kg. (iv), bed rest.

Beryllium

Calcium edentate, Prednisolone.

Bis-chloro methyl ether

N-acetyl-L-cysteine.

Bleaching solution

Milk, melted ice-cream, eggs, milk of magnesia, aluminium hydroxide gel. Do not give acid antidotes.

Bromides

Skin is affected then wash with plenty of water. Give 1 gm. Salt in water by mouth. If this is not possible then intravenous (iv) injection of normal saline. Give milk and water.

Boric acid and Boron derivatives

Ipecac solution and activated charcoal. Infra muscular (im) injection of 5% dextrose if nausea.

Cadmium

Calcium disodium edetate i.e. CaNa2EDTA by intravenous or muscle.

Carbon monoxide

Administer Oxygen (100% pure), intravenous injection of 1 gm/kg of 20%mannitol, or 1 mg./ kg of Prednisolone.

Carbon tetrachloride or Chloroform

N- acetyl -L- cysteine.

Carbonyls

Tablets of Sodium diethyl dithio carbamate, 2 tablets immediately and then 1 tablet every two days for next two days. Administer Oxygen in case of breathing difficulty.

Cardiac Glycosides

Potassium chloride (0.5% solution). Atropine sulphate (0.1% solution), Tefacin calcium (10% solution).

Chlorine, Bromine, Phosgene

Skin is affected then wash with plenty of water. Apply Sodium bicarbonate and again wash with water. Eye is affected then flush eye in eye fountain. Put 2-3 drops in eye of Pontocaine 0.5% solution ot Benzocaine (Novocain) 0.4% solution. If inhaled then give smell through ethanol or ether dipped cotton. ; Give milk, buttermilk or lemon water. Give 02 in case of breathing difficulty.

Chlorates

Ipecac solution, activated charcoal, milk. Don't give Methylene blue. Add 2 to 5 gms. Sodium thiosulphate in 200 ml of 5% Sodium bicarbonate solution and give by mouth.

Cosmetics (Bromates)

Intravenous injection of 1 ml./kg Sodium thiosulphate (10% solution) .

Chromium

Dimercaprol.Give high vitamins, protein and carbohydrates in food. Methylene blue.

Cyanides and Thiocyanate insecticides

Methylene blue or Calocyanides injection. If inhaled gives smell of amyl nitrate ampule (0.2 ml) every 5 minutes. Intravenous injection of Sodium nitrite (3% solution) and Sodium thiosulphate (25% solution) but if blood pressure decreases, then stop it. 4 DMAP (Dimethyl amino phenol) 3 mg/kg, iv, along with thiosulphate. Hydroxocobalamine, 4 gm,iv, in 5% dextrose. Dicobalt edetate, 300 - 600 mp-, iv, over l-5min.

DDT (Halogenated insecticides)

Ipecac syrup, activated charcoal. Saline cathartic, Diazepam (10 mg.) by intravenous injection, wash skin with soap and water. In case of breathing difficulty administer Oxygen.

. Dichlorophenoxy acetic acid insecticides

Ipecac syrup, activated charcoal. Saline cathartic, Lidocane (50-100 mg by intravenous injection).

Dimethyl sulphate

Skin is affected then apply Magnesium oxide paste and give injection of Corticosteroid. In case of breathing difficulty administer Oxygen.

Dichloro methane

Hydro cortisone (200 mg every 4 hours). In case of aspiration pneumonia give antibiotics.

Dinitrophenol or Cresols

5% Glucose saline by intravenous injection.

Ethanol

2 gm. Of Sodium bicarbonate in 250 ml water, Diazepam 10 mg., by intravenous. Skin or eye is affected then wash with plenty of water.

Ethylene or Diethylene glycol

Ethanol, Calcium gluconate Pyridoxine .

Fluorine, Hydrogen fluoride and derivatives.

Intravenous injection of 10 ml. Calcium gluconate (10% solution). If serum magnesium level is low then give 10 ml Milk of magnesia every hour. Give more milk and liquids. If eye is affected then wash with plenty of water.

Formaldehyde

Milk, activated charcoal or water.

Formalin

Ammonium chloride or Ammonium carbonate (3% solution).

Hydrogen sulphide, other sulphides and Mercaptans

Shift in fresh air or administer Oxygen. Give inhalation of ethanol or ether drops. Amyl nitrite or Sodium nitrite, Pyridoxine 20 mg./kg. or 10% urea 1 gm./kg by intravenous injection.

Hydrogen cyanide

Give inhalation of 0.2 ml amyl nitrite dipped cotton. Sodium nitrite (1% solution). Sodium thiosulphate (30% solution), Cromosmon (1% methylene blue in 25 % glucose solution).

Iodine and compositions

Milk, Fine starch solution, 100 ml of 1% Sodium gluconate 10% solution.

Iron salts

Careful treatment of deferroxamine therapy.

Lead compounds

CaNa2 EDTA, D-Penicilliamine (oral), BAL (with CaEDTA), Induce vomiting, then give Magnesium sulphate in water.

Magnesium salts

Intravenous injection of 1 ml/ kg of Calcium gluconate 10% solution.

Manganese

Calcium edentate.

Mercury as Hg, Alkyl or Aryl compounds

Give white of egg in water. Later give milk, Then induce vomiting. BAL, D-Pencilliamine, n- Acetylcysteine, Dimercaptopropane- 1 sulfonate DMPS).

Metals (Heavy metals, mercury, lead, copper, cobalt, arsenic, nickel)

Unithol (BAL, dimercaprol, 5% solution), Tetacin calcium (10% solution), Penicillamine Dextrose (10%) by intravenous injection. Chillating agent for effect of mercury.

Metal Compounds (Heavy metals compositions)

Activated carbon (carbolin) BAL .

Methanol

Ethanol (30% solution from inside, 5% solution from outside i.e. by intravenous injection), Epicake Syrup. In case of acidosis give Sodium bicarbonate. In case of delirium give Diazepam 10 mg. by intravenous injection. Folinic acid (Leucovorin), 1 mg/kg, iv, 4 hourly.

Metaldehyde

D-Penicillamine, Ascorbic acid or Thiamine to be given carefully.

Naphthalene 5 gm.

Sodium bicarbonate every 4 hrs. and keep urine alkaline. Give 1 ml/kg, furosemide in liquid. Blood transfusion till haemoglobin becomes normal -60 to 80%.

Nitrates, Nitrites, Nitrobennzene Sulfonamides Dapsone

Methylene blue, 1-2 mg / kg, iv, over 5 min.

Nitrogen oxides (NOx)

Prednison or prednisolone 5 mg. every 6 hrs. interval.

Orgnaic phosphate or carbamate insecticides (abet, dizionon, dimate, EPN, Ethyl Phosphamidon, Phosvel, Selithion, Aldecarb, Baygon, Sevin etc.)

Ipecac syrup, Atropine sulphate 2 mg. by intravenous injection every 3-8 mins interval. Prelidoxim by intravenous. Obidoxim (Toxogonin), skin to be washed with soap and water.

Orgao phosphorous insecticides (e.g. Malathion, Parathion, Monocrotophos, Phorate)

Atropine injection, atropine sulphate (0.1% solution), Nalorphine hydrochloride (0.5% solution), Trimedoxim bromide (15% solution), Pyridine Aldoxy Methyodate, Diperoxim, Biodexim and Isonitrocin (40% solution), Pralidoxim, RAM, TOXOGONIN.

Oxalic acid

Milk, lemon water, chalk or calcium lactate, calcium chloride or calcium gluconate with liquid. 10% calcium gluconate or chloride 10 ml. by intravenous injection.

p-Nitro Chlorobenzene (PNCB)

Methylene blue .

Phenol & Derivatives

Shift in fresh air, activated charcoal and 240 ml. milk. If skin or eye is affected then wash with plenty of water for 15 min. If skin is affected then wash with Polyethylene glycol(PEG).

Phosgene

Cortisone acetate 1 mg./kg by mouth - thrice a day. In case of breathing difficulty administer Oxygen.

Phosphorous, Phosphine & Phosphides

10 ml. Calcium gluconate (10%) by intravenous injection, 5% glucose in water. Travert (10% invert sugar) by intravenous injection.

Potassium permanganate

Hot milk, Methylene blue (1% solution) Ascorbic acid (5% solution).

Silica & Asbestos dust

Reduce dust level by local exhaust ventilation. Use airline respirator.

Silver nitrate & other salts 10%

Salt (Sodium chloride) solution, milk and for reducing, pain Demrol or Codeine.

Tobacco & Nicotine

Induce vomiting, Atropine (large dose).In case of difficulty in breathing, administer Oxygen.

Vinyl chloride

Skin is affected, wash with plenty of water. Eye is affected then keep eye open and allow material to vaporise. Don't apply any eye drops In case of breathing difficulty, administer Oxygen. If injected then induce vomiting. Give one spoon mineral oil and after that give sodium/magnesium sulphate (one spoon) in a glass of water. Give strong tea or coffee if feeling exhausted.

23st feb 2024 by admin

Fire Prevention

The main factors for combustions are presence of oxygen, availability of combustible materials and rise of temperature to the ignition point for the material The cause of fire accidents may be electric-short circuit.

23st feb 2024 by admin

Personal Protective Equipment

23st feb 2024 by admin

Health Hazards and control measures in Industrial Areas

Effects of dusts, fumes, heat, noise and vibration due to hot and cold working of metals and crush and other injuries due to machine tools are discussed earlier.

24st feb 2024 by admin

First Aid

sometimes accidents may also occur in industries. After major or minor accidents, an injured worker requires immediate preliminary treatment in the absence of same his condition may become highly critical.

24st feb 2024 by admin

Cupola Furnace

sA Cupola furnace is utilized for melting recycled metal or pig iron to manufacture diverse cast irons. Crucial factors in choosing cupolas include melting capability, shell diameter with or without lining, and spark arrestor.

24st feb 2024 by admin