Digoxin has 60-80% bioavailability, a mean plasma half-life of 40 h and a volume of distribution (Vd) of 5-10 L/kg and low protein binding (20%). In preparing this Position Statement, all relevant scientific literature was identified and reviewed critically by acknowledged experts using agreed criteria. The benefits of their use thus outweigh the costs. A US perspective. This applies also to agricultural activities in which workers may be exposed to both agrochemicals and natural toxins (for example, through the bites of venomous animals) at certain times of the year, such as the planting, crop-spraying, and harvesting seasons. There are no specific antidotes for chromium poisoning.

Serial red cell cyanide concentrations in ewes and fetuses were followed. This review provides an overview of the role of antidotes in poisoning. Activated charcoal is commonly used in the treatment of patients experiencing an oral overdose of drugs and is considered to be a safe, inert agent. An almost 100% efficacy is seen using specific antagonists, such as naloxone in opiate poisoning or flumazenil in benzodiazepine poisoning, e.g. Previous recommendations used ≥50 mg/dL (15.6 mmol l−1) as a threshold for haemodialysis in fomepizole‐treated patients or if the patient displayed visual loss or severe metabolic acidosis 84. 2010;100:397-460. doi: 10.1007/978-3-7643-8338-1_12. There were few adverse events. A peripheral intravenous cannula was inserted, as were indwelling arterial and urinary bladder catheters. Mechanism of action of antidotes: Countries should select from the list of essential antidotes those agents that are most appropriate to their needs; in some cases, these drugs are already listed in the WHO List of Essential Drugs.1. A draft Position Statement was then produced and subjected to detailed peer review by an international group of clinical toxicologists chosen by the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. Non-specific poisons except cyanide, iron, lithium, caustics and alcohol.

In general, 40-120 mg (1-3 vials) should be sufficient. As previously mentioned, a universal reactivator has yet to be found. Ethylene glycol is metabolized to glycolic acid, the major acidic metabolite 35 and then to oxalic acid. Chelation of lead ions and endogenous metals (e.g., zinc, manganese, iron, copper). Examples of mechanisms by which antidotes work include competition at a receptor site, alteration of a metabolic process, engaging a counter-regulatory physiologic process, or hastening the excretion or detoxification of a toxin. DOI: Development of seizures after flumazenil administration was significantly associated with exposure to a pro-convulsant drug (odds ratio 3.41; 95% confidence interval 1.13-10.72). Mortality did not differ between the groups. A central "bank" of antidotes could be an economic and effective means of ensuring distribution, and this should be organized by health authorities in such a way that any poison victim may be assured of receiving an antidote within the appropriate period of time. The term urine alkalinization emphasizes that urine pH manipulation rather than a diuresis is the prime objective of treatment; the terms forced alkaline diuresis and alkaline diuresis should therefore be discontinued. The need for intubation was similar in both groups (pralidoxime 26/121 [21.5%], placebo 24/114 [21.1%], adjusted HR 1.27 [95% CI 0.71-2.29]). Problems generally arose in the following three interrelated areas: *scientific, technical, and economic considerations, *regulatory and administrative requirements. There is enough evidence that the proper use of specific antidotes when combined with general supportive care does reduce the morbidity and mortality associated with severe poisonings. Information programmes should be arranged by toxicological and poison information centres in order to familiarize clinical personnel with the proper use of antidotes, particularly for individuals in high-risk groups, such as those exposed to hazardous chemicals in the course of their work.

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