Toxicology

Antidotes

• N-Acetylcysteine (load)

  Acetaminophen OD

  IV
  Dose

  10500 mg

  Volume

  52.5 mL
  IV over 60 min• 200 mg/mL• 150 mg/kg

• Naloxone

  Opioid reversal

  IV/IM/IN
  Dose

  2.00 mgMax

  Volume

  5.00 mL
  ⚠Capped at max dose — Max single dose: 2.00 mg
  IV/IM/IN• 0.4 mg/mL• 0.1 mg/kg

• Flumazenil

  Benzo reversal (caution)

  IV
  Dose

  0.200 mgMax

  Volume

  2.00 mL
  ⚠Capped at max dose — Max single dose: 0.200 mg
  IV slow• 0.1 mg/mL• 0.01 mg/kg

• Sodium Bicarb (TCA)

  TCA OD with QRS widening

  IV
  Dose

  100 mEqMax

  Volume

  100 mL
  ⚠Capped at max dose — Max single dose: 100 mEq
  IV bolus• 8.4% (1 mEq/mL)• 2 mEq/kg

• Calcium Gluconate

  CCB/HF OD, hyperK+, hypoCa

  IV
  Dose

  3000 mgMax

  Volume

  30.0 mL
  ⚠Capped at max dose — Max single dose: 3000 mg
  IV slow• 10% (100 mg/mL)• 60 mg/kg

• Hydroxocobalamin

  Cyanide / smoke inhalation

  IV
  Dose

  4900 mg

  Volume

  196 mL
  IV over 15 min• 25 mg/mL• 70 mg/kg

• Sugammadex

  Roc/Vec reversal

  IV
  Dose

  1120 mg

  Volume

  11.2 mL
  IV bolus• 100 mg/mL• 16 mg/kg

  16 mg/kg for immediate reversal; 4 mg/kg deep block; 2 mg/kg routine. Vecuronium reversal: 4 mg/kg.

Common antidotes (quick ref)