The Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island

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The Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island Poison Potential Antidote Acetaminophen n-Acetylcysteine [Mucomyst®] Anticholinergics Physostigmine [Antilirium®] Benzodiazepines Flumazenil [Romazicon®] Beta-adrenergic blockers Glucagon Botulinum toxin Trivalent ABE botulinum antitoxin Calcium chloride or calcium gluconate Calcium channel blockers Hyperinsulinemia-euglycemia (HIE) therapy Atropine Carbamates Pralidoxime (2-PAM) [Protopam®] Carbon monoxide Oxygen; Hyperbaric oxygen (HBO) Clonidine Naloxone [Narcan®] Cyanide Cyanide Kit (Amyl/sodium nitrite, sodium thiosulfate) Digoxin (Cardiac glycosides) Digoxin Immune FAB Ovine [Digibind®, Digifab®] Epi Pen (Epinephrine SQ) Phentolamine [Regitine®] Ethanol Ethylene glycol 4-Methylpyrazole (Fomepizole) [Antizol®] Fluoride Calcium chloride or calcium gluconate Heparins Protamine Hydrofluoric acid Calcium chloride or calcium gluconate Hydrogen sulfide Oxygen; Hyperbaric oxygen (HBO); Sodium nitrite Iodine Starch Isoniazid Pyridoxine (Vitamin B6 ) METALS Dimercaprol [BAL] Arsenic Dimercaptosuccinic acid (DMSA, succimer) [Chemet®] Bismuth Dimercaprol [BAL] Copper D-Penicillamine [Cuprimine®] Gold Dimercaprol [BAL] Iron Deferoxamine [Desferal®] Dimercaprol [BAL] Edetate calcium disodium (Calcium EDTA) Lead Dimercaptosuccinic acid (DMSA, succimer) [Chemet®] D-Penicillamine [Cuprimine®] Dimercaprol [BAL] Mercury Dimercaptosuccinic acid (DMSA, succimer) [Chemet®] Ethanol Methanol 4-Methylpyrazole (Fomepizole) [Antizol®] Methemoglobinemic agents Methylene blue Methotrexate Folinic acid (Leucovorin) MUSHROOMS Amanita phalloides n-Acetylcysteine [Mucomyst®] Clitocybe, Inocybe Atropine Gyromitra Pyridoxine (Vitamin B6) Amantadine [Symmetrel®] Neuroleptic malignant syndrome Bromocriptine [Parlodel®] Dantrolene [Dantrium®] Opioids Naloxone [Narcan®] Atropine Organophosphates Pralidoxime (2-PAM) [Protopam®] Oxalates Calcium chloride or calcium gluconate Diphenhydramine [Benadryl®] Phenothiazines Benztropine [Cogentin®] Cyproheptadine [Periactin®] Serotonin syndrome Methysergide [Sansert®] SNAKES Polyvalent Crotalidae FAB - Ovine [CroFab®] Crotalid (pit viper) Antivenin Crotalidae Polyvalent – Equine Elapid (coral) Antivenin Micrurus fulvius Spider (black widow) Antivenin Lactrodectus mactans Sulfonylureas Octreotide [Sandostatin®] Tricyclic antidepressants Sodium bicarbonate Valproic acid Levocarnitine [Carnitor®] Warfarin / Superwarfarins Vitamin K (Phytonadione) This educational poster is not intended for individual patient care. Please call the poison center for patient specific management advice. 1-800-222-1222 (Consultations Available 24-hours a day) .

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Management of Poisoning
MOH CLINICAL PRACTICE GUIDELINES December/2011 Management of Poisoning Health Ministry of Sciences Chapter of Emergency College of College of Family Manpower Authority Physicians Physicians, Physicians Academy of Medicine, Singapore Singapore Singapore Singapore Medical Pharmaceutical Society Society for Emergency Toxicology Singapore Paediatric Association of Singapore Medicine in Singapore Society (Singapore) Society Executive summary of recommendations Details of recommendations can be found in the main text at the pages indicated. Principles of management of acute poisoning – resuscitating the poisoned patient GPP In a critically poisoned patient, measures beyond standard resuscitative protocol like those listed above need to be implemented and a specialist experienced in poisoning management should be consulted (pg 55). GPP D Prolonged resuscitation should be attempted in drug-induced cardiac arrest (pg 55). Grade D, Level 3 1 C Titrated doses of naloxone, together with bag-valve-mask ventilation, should be administered for suspected opioid-induced coma, prior to intubation for respiratory insufﬁ ciency (pg 56). Grade C, Level 2+ D In bradycardia due to calcium channel or beta-blocker toxicity that is refractory to conventional vasopressor therapy, intravenous calcium, glucagon or insulin should be used (pg 57). Grade D, Level 3 B Patients with actual or potential life threatening cardiac arrhythmia, hyperkalaemia or rapidly progressive toxicity from digoxin poisoning should be treated with digoxin-speciﬁ c antibodies (pg 57). Grade B, Level 2++ B Titrated doses of benzodiazepine should be given in hyperadrenergic- induced tachycardia states resulting from poisoning (pg 57). Grade B, Level 1+ D Non-selective beta-blockers, like propranolol, should be avoided in stimulant toxicity as unopposed alpha agonism may worsen accompanying hypertension (pg 57).
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Review of Succimer for Treatment of Lead Poisoning
Review of Succimer for treatment of lead poisoning Glyn N Volans MD, BSc, FRCP. Department of Clinical Pharmacology, School of Medicine at Guy's, King's College & St Thomas' Hospitals, St Thomas' Hospital, London, UK Lakshman Karalliedde MB BS, DA, FRCA Consultant Medical Toxicologist, CHaPD (London), Health Protection Agency UK, Visiting Senior Lecturer, Division of Public Health Sciences, King's College Medical School, King's College , London Senior Research Collaborator, South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, Peradeniya, Sri Lanka. Heather M Wiseman BSc MSc Medical Toxicology Information Services, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK. Contact details: Heather Wiseman Medical Toxicology Information Services Guy’s & St Thomas’ NHS Foundation Trust Mary Sheridan House Guy’s Hospital Great Maze Pond London SE1 9RT Tel 020 7188 7188 extn 51699 or 020 7188 0600 (admin office) Date 10th March 2010 succimer V 29 Nov 10.doc last saved: 29-Nov-10 11:30 Page 1 of 50 CONTENTS 1 Summary 2. Name of the focal point in WHO submitting or supporting the application 3. Name of the organization(s) consulted and/or supporting the application 4. International Nonproprietary Name (INN, generic name) of the medicine 5. Formulation proposed for inclusion 6. International availability 7. Whether listing is requested as an individual medicine or as an example of a therapeutic group 8. Public health relevance 8.1 Epidemiological information on burden of disease due to lead poisoning 8.2 Assessment of current use 8.2.1 Treatment of children with lead poisoning 8.2.2 Other indications 9.
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GHS Calcium Lactate Gluconate MSDS.Pdf
Safety Data Sheet (Calcium Lactate Gluconate) DATE PREPARED: 7/9/2015 Section 1. Product and Company Identification Product Name Calcium Lactate Gluconate CAS Number 11116-97-5 Parchem - fine & specialty chemicals EMERGENCY RESPONSE NUMBER 415 Huguenot Street CHEMTEL New Rochelle, NY 10801 Toll Free US & Canada: 1 (800) 255-3924 (914) 654-6800 (914) 654-6899 All other Origins: 1 (813) 248-0585 parchem.com [email protected] Collect Calls Accepted Section 2. Hazards Identification Classification of the substance or mixture Classification according to Directive 67/548/EEC or 1999/45/EC as amended: This preparation does not meet the criteria for classification according to Directive 1999/45/EC as amended. Classification according to Regulation (EC) No 1272/2008 as amended: This mixture does not meet the criteria for classification according to Regulation (EC) 1272/2008 as amended. Hazard and precautionary statements Hazard statements: The substance does not meet the criteria for classification. Precautionary statements: Not available. Appearance & Odor: White powder with no odor. Fire & Explosion Hazards Potential for dust explosion may exist. This product is not defined as flammable or combustible. However, the product may decompose under fire conditions to produce toxic oxides of carbon. Depending upon conditions, dusts may be sensitive to static discharge. Avoid possibility of dry powder and friction causing static electricity in presence of flammables (See NFPA-77, Chpt. 6) Primary Route of Exposure: Skin and eye contact are the primary routes of exposure to this product. Inhalation Acute Exposure: Inhalation of dust may cause mild irritation. Skin Contact - Acute: Skin contact is not expected to cause irritation.
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Wednesday May 26, 1999
5±26±99 Vol. 64 No. 101 Wednesday Pages 28333±28712 May 26, 1999 federal register 1 VerDate 06-MAY-99 21:29 May 25, 1999 Jkt 183247 PO 00000 Frm 00001 Fmt 4710 Sfmt 4710 E:\FR\FM\26MYWS.XXX pfrm03 PsN: 26MYWS II Federal Register / Vol. 64, No. 101 / Wednesday, May 26, 1999 The FEDERAL REGISTER is published daily, Monday through SUBSCRIPTIONS AND COPIES Friday, except official holidays, by the Office of the Federal Register, National Archives and Records Administration, PUBLIC Washington, DC 20408, under the Federal Register Act (44 U.S.C. Subscriptions: Ch. 15) and the regulations of the Administrative Committee of Paper or fiche 202±512±1800 the Federal Register (1 CFR Ch. I). The Superintendent of Assistance with public subscriptions 512±1806 Documents, U.S. Government Printing Office, Washington, DC 20402 is the exclusive distributor of the official edition. General online information 202±512±1530; 1±888±293±6498 Single copies/back copies: The Federal Register provides a uniform system for making available to the public regulations and legal notices issued by Paper or fiche 512±1800 Federal agencies. These include Presidential proclamations and Assistance with public single copies 512±1803 Executive Orders, Federal agency documents having general FEDERAL AGENCIES applicability and legal effect, documents required to be published Subscriptions: by act of Congress, and other Federal agency documents of public Paper or fiche 523±5243 interest. Assistance with Federal agency subscriptions 523±5243 Documents are on file for public inspection in the Office of the Federal Register the day before they are published, unless the issuing agency requests earlier filing.
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WO 2014/195872 Al 11 December 2014 (11.12.2014) P O P C T
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/195872 Al 11 December 2014 (11.12.2014) P O P C T (51) International Patent Classification: (74) Agents: CHOTIA, Meenakshi et al; K&S Partners | Intel A 25/12 (2006.01) A61K 8/11 (2006.01) lectual Property Attorneys, 4121/B, 6th Cross, 19A Main, A 25/34 (2006.01) A61K 8/49 (2006.01) HAL II Stage (Extension), Bangalore 560038 (IN). A01N 37/06 (2006.01) A61Q 5/00 (2006.01) (81) Designated States (unless otherwise indicated, for every A O 43/12 (2006.01) A61K 31/44 (2006.01) kind of national protection available): AE, AG, AL, AM, AO 43/40 (2006.01) A61Q 19/00 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, A01N 57/12 (2006.01) A61K 9/00 (2006.01) BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, AOm 59/16 (2006.01) A61K 31/496 (2006.01) DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (21) International Application Number: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, PCT/IB20 14/06 1925 KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (22) International Filing Date: OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, 3 June 2014 (03.06.2014) SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, (25) Filing Language: English TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW.
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Chelating Drug Therapy: an Update
Open Access Austin Journal of Genetics and Genomic Research Review Article Chelating Drug Therapy: An Update Vijay Kumar1, Ashok Kumar2*, Sandeep Kumar Singh1, Manoj Kumar3, Surendra Kumar2, Dinesh Abstract 4 5 Kumar and Ragni Singh Purpose: To study the clinical effects of metal toxicity and current 1Department of Neurology, SGPGIMS, India recommendations for management, including chelation therapy, are reviewed. 2Department of Medical Genetics, SGPGIMS, India 3Department of Microbiology, SGPGIMS, India Summary: Metals are essential to many biological processes, but excess 4Department of Chemistry, Dr. R.M.L. Avadh University, of it becomes hazardous to life. These are necessary for cell growth, electron India transport chain, several enzymatic activities and response of immune systems. 5Bheem Rao Ambedkar Bihar University, India They also serve as a cofactor for several enzymes. Chelation therapy is used for clinical management of the excess of metal. However, each metal requires *Corresponding author: Ashok Kumar, Department a specific chelation agent. A chelate is a compound form between metal and a of Medical Genetics, Sanjay Gandhi Post Graduate compound that contains two or more potential ligands. A promising Fe chelator Institute of Medical Sciences, Lucknow, India is Desferrioxamine (Desferal). Penicillamine and Trientine are uses for copper Received: March 12, 2015; Accepted: April 24, 2015; chelation. Meso-2,3-Dimercaptosuccinic Acid (DMSA) and 2,3-Dimercapto- Published: April 27, 2015 Propanesulphonate (DMPS) can be used as effective chelator of mercury. Dimercaprol, edetate calcium disodium, and succimer are the three agents primarily used for chelation of lead. Conclusion: Metal toxicity remains a significant public health concern. Elimination of elevated metal ions can be achieved by proper chelation agents.
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Calcium Gluconate
CALCIUM GLUCONATE CLASSIFICATION Minerals and electrolytes TRADE NAME(S) Calcium Gluconate 10% (for IV use) Calcium Gluconate gel 2.5% (for topical use) DESIRED EFFECTS Lower potassium levels; pain relief and neutralizing fluoride ion MECHANISM OF ACTION Calcium is the primary component of skeletal tissue. Bone serves as a calcium depot and as a reservoir for electrolytes and buffers. INDICATIONS Suspected hyperkalemia in adult PEA/Asystole Antidote for calcium channel blocker overdose and magnesium sulfate toxicity Gel is used for hydrofluoric acid burns Suspected hyperkalemia with adult crush injury or peaked T-waves on EKG CONTRAINDICATIONS Should not be given to patients with digitalis toxicity Should be used with caution in patients with dehydration ADVERSE REACTIONS When given too rapidly or to someone on digitalis, can cause sudden death from ventricular fibrillation May cause mild to severe IV site irritation SPECIAL CONSIDERATIONS Must either use a different IV line or flush line with copious normal saline if being given with sodium bicarbonate. When used on hydroflouric acid burns, relief of pain is the only indication of treatment efficacy. Therefore, use of analgesic agents is not recommended. DOSING REGIMEN Suspected hyperkalemia in adult PEA/asystole or adult crush injury, or evidence of EKG changes (Ex. peaked T-waves) o Calcium gluconate 10% 15-30 ml IV/IO over 2-5 minutes KNOWN calcium channel blocker overdose - administer 3 grams IV/IO may repeat dose in 10 minutes if no effect. Hydrofluoric acid burns apply calcium gluconate gel 2.5% every 15 minutes to burned area and massage continuously until pain disappears.
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Changes in Tissue Gadolinium Biodistribution Measured in an Animal Model Exposed to Four Chelating Agents
Japanese Journal of Radiology (2019) 37:458–465 https://doi.org/10.1007/s11604-019-00835-1 ORIGINAL ARTICLE Changes in tissue gadolinium biodistribution measured in an animal model exposed to four chelating agents Türker Acar1,6 · Egemen Kaya2 · Mustafa Deniz Yoruk3 · Neslihan Duzenli4 · Recep Selim Senturk4 · Cenk Can4 · Lokman Ozturk3 · Canberk Tomruk5 · Yigit Uyanikgil5 · Frank J. Rybicki6 Received: 17 December 2018 / Accepted: 22 March 2019 / Published online: 30 March 2019 © Japan Radiological Society 2019 Abstract Purpose This study investigated the potential to reduce gadolinium levels in rodents after repetitive IV Gadodiamide admin- istration using several chelating agents. Materials and methods The following six groups of rats were studied. Group 1: Control; Group 2: Gadodiamide only; Group 3: Meso-2,3-Dimercaptosuccinic acid (DMSA) + Gadodiamide; Group 4: N-Acetyl-L-cysteine (NAC) + Gadodiamide; Group 5: Coriandrum sativum extract + Gadodiamide; and Group 6: Deferoxamine + Gadodiamide. Brain, kidney, and blood samples were evaluated via inductively coupled plasma mass spectrometry. The brain was also evaluated histologically. Results Kidney gadolinium levels in Groups 4 and 5 were approximately double that of Group 2 (p = 0.033 for each). There was almost no calcifcation in rat hippocampus for Group 4 rodents when compared with Groups 2, 3, 5 and 6. Conclusion Our preliminary study shows that excretion to the kidney has a higher propensity in NAC and Coriandrum sati- vum groups. It may be possible to change the distribution of gadolinium by administrating several agents. NAC may lower Gadodiamide-induced mineralization in rat hippocampus. Keywords Gadolinium deposition · Dimercaptosuccinic acid · N-Acetyl-L-cysteine · Coriandrum sativum · Deferoxamine Introduction However, the safety profle of gadolinium-based agents [1] was questioned after the discovery of nephrogenic sys- Gadolinium-based contrast agents (GBCA) have been safely temic fbrosis [2], a scleroderma-like disease characterized used in diagnostic radiology since the 1980s.
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Recommended Chelation Protocol for Children with Blls ≥45 Μg/Dl
The New York City Department of Health and Mental Hygiene Guidelines for Health Care Providers Recommended Chelation Protocol for Children With BLLs ≥45 μg/dL Before Providing Chelation Therapy: • Confirm the blood lead level (BLL) ≥45 μg/dL with a venous specimen processed as an emergency test unless symptoms of encephalopathy are present. • Obtain an abdominal x-ray to look for lead solid ingestion; if radio-opaque particles are found or recent ingestion is witnessed, use a cathartic. • Arrange hospitalization and chelation therapy at a facility with expertise in treating lead-poisoned children. • Provide chelation therapy in, and discharge child to, a lead-safe environment. Do not discharge until the NYC Health Department inspects the home. • Inform the NYC Health Department of the hospital admission by calling 646-632-6002. The Health Department can provide referrals to providers with expertise in treating lead intoxication and referrals to temporary lead-safe housing. Chelation Therapy For Children with Venous BLLs ≥45 μg/dL1 BLL (μg/dL) Agent, Dosage,* and Administration Special Considerations Follow-up <45 Chelation therapy not routinely recommended See Reverse for Recommended Follow-up Blood Lead Test Schedule for Children 45 to <70 • DMSA (succimer, 2,3-meso-dimercaptosuccinic acid) • Monitor for anemia, • Schedule weekly health care visits • 1050 mg DMSA / m2 / 24 hours* ÷ q8 hours PO x neutropenia, and to monitor compliance and signs of toxicity. 5 days; round dose to nearest 100 mg/day, and then hepatic toxicity. • Monitor BLLs weekly until level stabilizes, ÷ 100-mg capsules as evenly as possible for q8-hour then follow Recommended Follow-up dosing schedule.
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Effect of Chromium(VI) on Serum Iron and Removal of Its Toxicity by Combining Deferasirox and Deferiprone Chelators in Rats
American Journal of Pharmacology and Toxicology 8 (4): 164-169, 2013 ISSN: 1557-4962 ©2013 Science Publication doi:10.3844/ajptsp.2013.164.169 Published Online 8 (4) 2013 (http://www.thescipub.com/ajpt.toc) Effect of Chromium(VI) on Serum Iron and Removal of its Toxicity by Combining Deferasirox and Deferiprone Chelators in Rats 1S. Jamil A. Fatemi, 1Marzieh Iranmanesh and 2Faezeh Dahooee Balooch 1Department of Chemistry, Faculty of Sciences, Islamic Azad University, Kerman Branch, Kerman, Iran 2Department of Chemistry, Faculty of Sciences, Shahid Bahonar University of Kerman, Kerman, Iran Received 2013-09-26, Revised 2013-10-21; Accepted 2013-10-30 ABSTRACT The present research is aimed to characterize the potential efficiency of two chelators after chromium(VI) administration for 60 days following two doses of 15 and 30 mg kg −1 chromium(VI) per body weight daily to male rats. However, the hypothesis that the two chelators might be more efficient as combined therapy than as single therapy in removing chromium(VI) from bood serum was considered. In this way, two known chelators deferasirox and deferiprone were chosen and tested in the acute rat model. Two chelators were given orally as a single or combined therapy for a period of one week. Chromium(VI) and iron concentrations in blood were determined by flame atomic absorption spectroscopy method. Chromium is one of the most widely used industrial metals. Several million workers worldwide are estimated to be exposed to chromium compounds in an array of industries. Chromium(VI) is more readily absorbed by both inhalation and oral routes. Ingestion of large amounts of chromium(VI) can lead to severe respiratory, cardiovascular, gastrointestinal, hepatic and renal damage and potentially death.
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Antidote Stocking Tier C
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AX Pharmaceutical Corp Product List
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