What are the primary uses of Mucomyst. How does Mucomyst work in the body. What are the common side effects of Mucomyst. How should Mucomyst be administered properly. What precautions should be taken when using Mucomyst. Are there any potential drug interactions with Mucomyst. How is Mucomyst used in cases of acetaminophen overdose.

Understanding Mucomyst: A Powerful Mucolytic Agent

Mucomyst, also known by its generic name acetylcysteine, is a versatile medication used in various medical contexts. Its primary function is to act as a mucolytic agent, helping to thin and loosen mucus in the airways. This property makes it particularly useful in treating certain respiratory conditions.

Primary Uses of Mucomyst

Mucomyst serves two main purposes in medical treatment:

1. Respiratory therapy: When inhaled, it helps manage conditions such as emphysema, bronchitis, cystic fibrosis, and pneumonia by facilitating mucus clearance from the lungs.
2. Acetaminophen overdose prevention: When taken orally, it acts as an antidote to prevent liver damage in cases of acetaminophen overdose.

How does Mucomyst work in respiratory therapy? The medication breaks down the disulfide bonds in mucus proteins, effectively thinning the mucus and making it easier to expel. This action helps improve breathing and reduce the risk of respiratory infections.

Administration Methods and Proper Usage of Mucomyst

The method of administration for Mucomyst varies depending on its intended use. For respiratory conditions, it is typically inhaled, while for acetaminophen overdose, it is taken orally.

Inhalation Method

When used as an inhalant, Mucomyst should be administered as directed by a healthcare professional. The process typically involves the following steps:

• Preparation of the solution according to medical instructions
• Use of a nebulizer or other approved inhalation device
• Proper breathing technique to ensure effective delivery to the lungs

Are there any special considerations when inhaling Mucomyst? Some patients may notice a slight odor upon initial inhalation, but this typically dissipates quickly. If using a face mask, residual stickiness may occur, which can be easily washed off with water.

Oral Administration

For acetaminophen overdose treatment, Mucomyst is taken orally. The solution is often mixed with another liquid, such as cola, to mitigate potential nausea and vomiting. It’s crucial to consume the medication within an hour of mixing.

What should you do if you vomit after taking Mucomyst? If vomiting occurs within an hour of ingestion, inform your doctor immediately, as a repeat dose may be necessary.

Common Side Effects and Their Management

While Mucomyst is generally well-tolerated, some patients may experience side effects. Understanding these potential reactions can help in managing them effectively.

Frequently Reported Side Effects

The most common side effects associated with Mucomyst include:

• Nausea and vomiting
• Mouth sores (when inhaled)
• Runny nose (when inhaled)

How can these side effects be managed? In many cases, these symptoms are mild and resolve on their own. However, if they persist or worsen, it’s important to consult with a healthcare provider.

Serious Side Effects Requiring Immediate Attention

While rare, some serious side effects may occur and require prompt medical attention:

• Severe abdominal pain
• Black stools
• Vomit resembling coffee grounds
• Chest pain or tightness
• Difficulty breathing

What should you do if you experience serious side effects? Seek immediate medical help if any of these symptoms occur, as they may indicate a severe reaction or complication.

Precautions and Considerations for Mucomyst Use

To ensure safe and effective use of Mucomyst, certain precautions should be observed. These considerations help minimize risks and optimize treatment outcomes.

Medical History and Allergies

Before starting Mucomyst treatment, it’s crucial to inform your healthcare provider about:

• Any known allergies, especially to acetylcysteine or other medications
• Complete medical history, with particular emphasis on asthma or stomach/intestinal ulcers
• All current medications, including over-the-counter drugs and herbal supplements

Why is disclosing your full medical history important? This information helps your doctor assess potential risks and tailor the treatment to your specific needs, reducing the likelihood of adverse reactions.

Pregnancy and Breastfeeding Considerations

The use of Mucomyst during pregnancy and breastfeeding requires careful consideration:

• Pregnancy: Mucomyst should only be used when clearly necessary, and the benefits outweigh potential risks
• Breastfeeding: It’s unknown if acetylcysteine passes into breast milk, so consultation with a healthcare provider is essential

What factors does a doctor consider when prescribing Mucomyst to pregnant or breastfeeding women? The severity of the condition being treated, potential risks to the fetus or infant, and available alternative treatments are all carefully weighed.

Potential Drug Interactions with Mucomyst

Understanding potential drug interactions is crucial for safe and effective use of Mucomyst. Certain medications may interact with acetylcysteine, altering its effectiveness or increasing the risk of side effects.

Common Drug Interactions

While not an exhaustive list, some medications known to interact with Mucomyst include:

• Certain antibiotics
• Nitroglycerin
• Activated charcoal

How can drug interactions be managed? Always inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and supplements. They can assess potential interactions and adjust your treatment plan accordingly.

Impact on Laboratory Tests

Mucomyst may interfere with certain laboratory tests, particularly urine ketone tests. This interference can lead to false results, potentially impacting medical decisions.

What should you do if you’re scheduled for laboratory tests while taking Mucomyst? Inform both your doctor and the laboratory personnel about your Mucomyst use to ensure accurate interpretation of test results.

Mucomyst in Acetaminophen Overdose Treatment

One of the critical uses of Mucomyst is in the treatment of acetaminophen overdose. Understanding its role in this context is essential for both healthcare providers and patients.

Mechanism of Action in Acetaminophen Overdose

In cases of acetaminophen overdose, Mucomyst acts as an antidote by:

• Replenishing glutathione stores in the liver
• Binding to toxic metabolites of acetaminophen
• Preventing liver damage caused by excessive acetaminophen

How quickly must Mucomyst be administered in cases of acetaminophen overdose? Time is critical in these situations, with the most effective treatment occurring within 8-10 hours of ingestion.

Dosage and Administration in Overdose Cases

The dosage of Mucomyst for acetaminophen overdose is carefully calculated based on several factors:

• Patient’s weight
• Estimated amount of acetaminophen ingested
• Time elapsed since ingestion

What is the typical treatment protocol for acetaminophen overdose using Mucomyst? Treatment usually involves an initial loading dose followed by maintenance doses over a 72-hour period, with close monitoring of liver function throughout.

Long-Term Effects and Monitoring During Mucomyst Treatment

While Mucomyst is generally safe for short-term use, understanding potential long-term effects and the importance of monitoring is crucial for patients on extended treatment plans.

Potential Long-Term Effects

Long-term use of Mucomyst, particularly when inhaled, may lead to:

• Increased bronchial secretions
• Potential changes in lung function
• Possible development of hypersensitivity reactions

How are long-term effects monitored? Regular check-ups, lung function tests, and assessment of symptoms are typically part of the monitoring process for patients on extended Mucomyst therapy.

Importance of Regular Monitoring

Ongoing monitoring during Mucomyst treatment serves several purposes:

• Assessing treatment effectiveness
• Identifying any adverse effects early
• Adjusting dosage or treatment plan as needed

What should patients report to their healthcare providers during follow-up visits? Any changes in symptoms, new side effects, or concerns about the medication’s effectiveness should be discussed promptly.

Alternative Treatments and Complementary Therapies

While Mucomyst is effective for many patients, understanding alternative treatments and complementary therapies can provide a more comprehensive approach to managing respiratory conditions or acetaminophen overdose.

Alternative Mucolytic Agents

For respiratory conditions, other mucolytic agents that may be considered include:

• Guaifenesin
• Hypertonic saline solutions
• Dornase alfa (for cystic fibrosis)

How do these alternatives compare to Mucomyst in terms of efficacy and side effects? The choice of mucolytic agent often depends on the specific condition being treated, patient response, and individual medical history.

Complementary Therapies for Respiratory Health

In addition to medication, various complementary therapies can support respiratory health:

• Chest physiotherapy
• Steam inhalation
• Proper hydration
• Breathing exercises

Can complementary therapies be used alongside Mucomyst? In many cases, these therapies can be safely combined with Mucomyst treatment, potentially enhancing overall effectiveness. However, it’s essential to consult with a healthcare provider before incorporating new therapies.

Patient Education and Self-Management Strategies

Empowering patients with knowledge and self-management strategies is crucial for optimizing Mucomyst treatment outcomes and overall health management.

Understanding Mucomyst Treatment

Key points for patients to understand about their Mucomyst treatment include:

• Proper administration techniques
• Expected effects and timeframe for improvement
• Recognition of side effects and when to seek medical attention
• Importance of adherence to prescribed dosage and schedule

How can patients ensure they’re using Mucomyst correctly? Regular communication with healthcare providers, asking questions, and requesting demonstrations of proper technique can help ensure correct usage.

Lifestyle Modifications to Support Treatment

In addition to medication, certain lifestyle changes can enhance the effectiveness of Mucomyst treatment:

• Maintaining good hydration
• Avoiding smoking and secondhand smoke exposure
• Practicing good hand hygiene to reduce infection risk
• Engaging in regular physical activity as appropriate for the condition

What role does diet play in supporting Mucomyst treatment? While no specific diet is required, a balanced, nutrient-rich diet can support overall health and potentially enhance the body’s response to treatment.

Advancements in Mucomyst Research and Future Prospects

The field of mucolytic therapy continues to evolve, with ongoing research into Mucomyst and related treatments offering promising prospects for future advancements.

Current Research Directions

Some areas of current research involving Mucomyst include:

• Exploring its potential neuroprotective properties
• Investigating its role in treating other liver conditions
• Developing new formulations for improved delivery and efficacy

How might these research directions impact future Mucomyst use? Findings from these studies could potentially expand the applications of Mucomyst beyond its current uses, offering new treatment options for various conditions.

Emerging Therapies and Combinations

Researchers are also exploring new therapies and combination treatments involving Mucomyst:

• Combining Mucomyst with other medications for enhanced effectiveness
• Developing targeted delivery systems for more precise treatment
• Investigating synergistic effects with other mucoactive agents

What potential benefits could these emerging therapies offer? These advancements could lead to more personalized treatment approaches, potentially improving efficacy and reducing side effects for patients.

Mucomyst: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

When inhaled by mouth, acetylcysteine is used to help thin and loosen mucus in the airways due to certain lung diseases (such as emphysema, bronchitis, cystic fibrosis, pneumonia). This effect helps you to clear the mucus from your lungs so that you can breathe easier.When taken by mouth, acetylcysteine is used to prevent liver damage from acetaminophen overdose.

How to use Mucomyst Solution

If you are using this medication to treat lung disease, inhale this medication by mouth as directed by your doctor. A health care professional will show you the proper way to use this medication. Learn all preparation and usage instructions.

You may notice a slight odor when you first breathe in the medication. This odor will quickly go away. If you are using a face mask to breathe in the medication, there may be some stickiness on your face after use. Wash your face with water to remove the stickiness.

Do not mix acetylcysteine with other inhaled medications unless directed by the doctor or pharmacist.

If you are taking this medication by mouth, take it as directed by your doctor. The solution is usually mixed with another liquid (such as cola) to decrease nausea and vomiting. Drink the medication within 1 hour of mixing.

Tell your doctor if you vomit within 1 hour after taking your medication. You may need to take another dose.

The dosage is based on your medical condition and response to treatment. For acetaminophen overdose, the dosage is also be based on your weight.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Nausea and vomiting may occur. Mouth sores and runny nose may also occur if you are inhaling this medication by mouth. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

If you are taking this medication by mouth, tell your doctor right away if you have any serious side effects, including: severe stomach/abdominal pain, black stools, vomit that looks like coffee grounds.

If you are inhaling this medication by mouth, get medical help right away if you have any very serious side effects, including: chest pain/tightness, trouble breathing.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using acetylcysteine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, stomach/intestinal ulcer.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

This medication may interfere with certain lab tests (such as urine ketone test), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Does Mucomyst Solution interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

For acetaminophen overdose, lab and/or medical tests (such as liver/kidney function, acetaminophen drug levels, blood mineral levels) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you are using this medication to treat lung disease and miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

If you are using this medication to treat acetaminophen overdose, it is important to take each dose as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

Store at room temperature away from light. After opening the vial, store in the refrigerator and use within 96 hours (4 days). The solution may change to a light purple color. This is normal and will not affect how the drug works. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Acetylcysteine Oral Inhalation: MedlinePlus Drug Information

pronounced as (a seet” il sis’ teen)

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Acetylcysteine inhalation is used along with other treatments to relieve chest congestion due to thick or abnormal mucous secretions in people with lung conditions including asthma, emphysema, bronchitis and cystic fibrosis (an inborn disease that causes problems with breathing, digestion, and reproduction). Acetylcysteine is in a class of medications called mucolytic agents. It works by thinning the mucus in the air passages to make it easier to cough up the mucus and clear the airways.

Acetylcysteine comes as a solution (liquid) and concentrated solution to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled). When using a nebulizer, it is usually used 3 to 4 times a day. When given by other methods, acetylcysteine should be used as directed. Use acetylcysteine at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use acetylcysteine exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Only mix acetylcysteine with other medications if instructed to do so by your doctor.

The concentrated solution of acetylcysteine should be mixed with normal saline or sterile water and used within an hour.

There may be a slight unpleasant odor when you use acetylcysteine that goes away quickly. In an opened bottle of acetylcysteine, there may be a color change to a light purple, but it will not affect use.

Acetylcysteine should only be used with nebulizers made of plastic or glass. Acetylcysteine should not be routinely used in a hand bulb operated nebulizer or put directly into a heated nebulizer. Talk to your doctor or pharmacist about the correct nebulizer to use with acetylcysteine.

Clean your nebulizer immediately following each use. If you do not clean your nebulizer properly, the nebulizer may become clogged and may not allow medication to be inhaled. Follow the manufacturer’s directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your nebulizer.

Acetylcysteine is also sometimes used to treat people who have taken or received an overdose of acetaminophen (Tylenol, others). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using acetylcysteine,

• tell your doctor and pharmacist if you are allergic to acetylcysteine, any other medications, or any of the ingredients in acetylcysteine inhalation. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
• tell your doctor if you have or have ever had asthma.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using acetylcysteine, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Acetylcysteine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• fever
• runny nose
• swelling of the inside of the mouth
• throat irritation
• drowsiness
• cool, moist skin

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:

• chest tightness
• wheezing
• difficulty breathing or swallowing
• coughing up blood
• hives
• rash
• itching

Acetylcysteine may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www. fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). After opening, keep this medication in the refrigerator, and dispose of any unused medication after 96 hours.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

• Mucomyst^®¶

• N-Acetylcysteine

^¶ This branded product is no longer on the market. Generic alternatives may be available.

Last Revised – 03/15/2017

Browse Drugs and Medicines

Why is an overdose of drugs dangerous and how to avoid it?

Medicine	Symptoms	Antidote/Emergency
Analgin	Tinnitus, nausea, vomiting, general weakness.	Gastric lavage, laxatives and diuretic.
Adrenaline (epinephrine)	Nausea, vomiting, tachycardia, pallor, cyanosis, chills, dilated pupils, tremor, convulsions, difficulty breathing.	Forced diuresis. When taken orally – gastric lavage. With tachycardia, anaprilin.
Amidopyrine (Butadione, Pyramidone)	Tinnitus, nausea, vomiting, general weakness, decrease in body temperature, shortness of breath, tachycardia.	Gastric lavage, forced diuresis, saline laxative, vitamin B1.
Anticoagulants (heparin, dicoumarin)	Hemorrhages, blood in the urine.	Vitamin K (Vikasol), forced diuresis.
Aspirin (acetylsalicylic acid)	Dizziness, tinnitus, hearing loss, visual disturbance, rapid breathing.	Gastric lavage, vaseline oil inside. With bleeding – vikasol.
Boric acid	Abdominal pain, vomiting, diarrhea, general weakness, headache. Skin changes. Absorbed through the gastrointestinal tract, damaged skin, so symptoms may appear even a day after ingestion.	Gastric lavage, forced diuresis. .
Digoxin and other cardiac glycosides	Nausea, vomiting; bradycardia or tachycardia, decreased blood pressure, cyanosis, convulsions. Symptoms of intoxication appear within the first hour.	Gastric lavage, saline laxative, oral sorbents.
Ergocalciferol (vitamin D₂)	Nausea, frequent vomiting, dehydration, lethargy, fever. Intoxication can develop as a result of a single dose of a large dose of the drug or with repeated use.	Detoxification measures, intramuscular corticosteroids.
Corticosteroids (hydrocortisone, dexamethasone, prednisolone, etc. )	Peripheral edema, increased blood pressure; CNS disorders.	Forced diuresis; inside potassium chloride.
Paracetamol	Anorexia, nausea, vomiting, right upper quadrant pain, weakness.	Oral use in the first 16 hours of acetylcysteine ​​(mucomist, mucosolvin). The antidote can also be administered intravenously by drip (with severe vomiting), however, the oral route is more effective and is associated with fewer side effects.
Iron preparations	Abdominal pain, vomiting, discolored stools. Symptoms of intoxication appear 15-30 minutes after ingestion.	1. Gastric lavage, oral sorbents.
Potassium permanganate (“potassium permanganate”)	Brown-purple color of the affected mucous membranes, their swelling; psychomotor agitation.	With severe cyanosis – methylene blue 50 ml of a 1% solution, ascorbic acid – 30 ml of a 5% solution intravenously.
Insulin	Symptoms of hypoglycemia: weakness, sweating, hand tremors, hunger.	Forced diuresis, intravenous administration of glucose, manitol. Intramuscular glucagon.
Iodine	Inhalation of iodine vapours, affects the upper respiratory tract. When concentrated solutions of iodine get inside, severe burns of the gastrointestinal tract develop.	Gastric lavage through a tube with sodium thiosulfate solution. Sodium thiosulfate 30% solution – up to 300 ml per day intravenously, 10% sodium chloride solution 30 ml intravenously.
Brilliant green mortar	Cyanosis of lips, ears, nails. Severe weakness, dizziness, headache.	Flushing with a weak solution of potassium permanganate in case of contact with the skin. When taken orally – abundant gastric lavage, the introduction of vaseline oil.

about antidotes for household poisoning) / Sudo Null IT News0176

Reading with interest the articles of my colleague gjf about the most interesting, scariest and most harmless poisons, I feel nostalgic :). Because any correct chemist, starting his creative path, is primarily interested in either poisons, or explosives, or drugs. I haven’t met people who would have been led into chemistry by something else, honestly. True, over the years, if a hobby becomes a profession, all information is somehow rethought and streamlined, completely different priorities arise. And now, reading the mentioned articles, I recalled my paper notebook, in which, among other things, there were descriptions of unusual poisons. Everything flows, everything changes, now in my “working” notebook there are more “antidotes”. For man has invented thousands of ways to destroy life, and so far not a single one has been invented to create it. Strength is in balance, so if there are poisons on Habré, there must be antidotes. Well, the permanently dormant sergeant of the Belarusian RKhBZ woke up in me. The article is short, almost without water, but it may turn out to be vital (= “bookmark”, FAQ on methanol)! For an antidote – go under the cat.

RU Wikipedia teaches us that:

Antidote or antidote (from other Greek ἀντίδοτον, lit. – given against) is a drug that stops or weakens the effect of poison on the body.

In principle, every adult has heard about antidotes at least once in his life. Someone, for example, from an article about the bezoar stomach stone, which has been used for centuries as a remedy for any poison (“remedy”). Someone will remember Rasputin, who ate sweet cakes and thereby saved himself from cyanide poisoning (

but this did not save from a bullet), but someone from Nicolas Cage from the movie The Rock, angrily driving atropine into the heart with an auto-injector.

It is worth recognizing that today antidotes as such have lost their relevance and most often in the memory of the layman are associated with civil defense courses ( posters on the walls of old research institutes ), or with films of the corresponding (terrorist, etc.) subject. This happened because intensive care in emergency medicine has reached unprecedented heights. Any poisoning is usually assessed and treated symptomatically, consistently blocking or removing damaging factors. However, the use of antidotes offers the advantage of shortening the development of poisoning and reducing complications, increases the chances of recovery of the poisoned patient and saves his vital resources. When full-fledged intensive care is not available, some antidotes can become life-saving medicines, especially in remote areas or developing regions.

Until a certain point, all antidotes were not classified and existed completely apart. But the situation changed in 1993, when the WHO International Program on Chemical Safety (IPCS) first redefined the term antidote:

Antidote is a therapeutic substance used to counter
side effects of the xenobiotic.

and secondly, a list was prepared and presented to the public, Guidelines for Poison Control . I recommend downloading it just in case and keeping it in a conspicuous place, even though IPCS experts are constantly conducting research and clarifying information (= supplementing the list, etc.).

Guidelines for Poison Control Cover

The list consists of the following tables:
tab. 1) 48 antidotes that have a positive effect in the treatment of certain acute poisonings
tab. 2) 12 substances used to prevent the absorption of poisons. They also provide symptomatic treatment
tab. 3) 19 therapeutic agents that have a positive effect in acute poisoning
tab. 4) 23 antidotes and concomitant therapeutic substances that are outdated and whose use is now not recommended due to inefficiency.

I will cite only the first and last tables in the article, as the most vital ones. The rest, if desired, an inquisitive reader can see for himself by clicking on the link mentioned above.

I would like to note that the WHO definition of the concept is very broad. It
includes both actual antidotes and non-specific drugs (for example, glucose, vitamin K, diazepam, isoprenaline, etc.), which are widely used in the treatment of specific poisonings.

In the table of antidotes in the column “code” the letter indicates the urgency of application:
A – use immediately (within the first 30 minutes from the moment of poisoning),
B – use immediately (within the first 2 hours),
With – application is necessary immediately (in the first 6 hours).

The number next to the letter identifies such a parameter as the evidence of the effectiveness of the drug: 1 – the effectiveness of the antidote is well documented, 2 – the antidote is widely used, but additional studies are required on the effectiveness and indications for use, 3 – the effectiveness is questionable.

IPCS Antidote Chart

Legend:

ANTIDOTE TABLE

Obsolete, ineffective and dangerous antidotes

Important note: Specific antidotes should be used

only in case of established poisoning with the corresponding specific poison, well, it is logical that in order to effectively eliminate the negative effects of poisoning, antidotes should be used as quickly as possible (as early as possible).

Addition : in response to “from the whole table – I know only 10-15 pieces …”. A few thoughts. For example, the antidote for thallium is Prussian blue , aka Prussian blue. It is not difficult for a chemist to get Prussian blue, since “ yellow blood salt ” and ferric salts are almost everywhere. The layman can be helped by Ferrocin tablets (originally positioned as a sorbent of radioactive cesium), which after the Chernobyl disaster could still be found, and then it suddenly became difficult. In extreme cases, you can try to look for the veterinary drug Bifezh, fed to animals in areas contaminated with radionuclides. As an emergency option, there is watercolor paint, where Prussian blue is used as a blue pigment. Take note that yellow blood salt is a food additive E536, which is put, for example, in Belarusian-made sprat in tomato :). Sodium thiosulfate – a photoreagent common in the past, the so-called. fixer (simple) neutral. Edetates – EDTA salts, metal complexes with Trilon-B (EDTA), which is used to soften water and is sold in every stall. One of the best complexing agents – perfectly chelates many heavy metals. Methionine is a sulfur-containing amino acid found in many foods (see USDA). Methylene blue is a common household blue, which is not a problem to get. Amyl nitrite is a poppers that can also be found in a large city without any problems. Etc. etc., if you figure it out – everything is not so sad and it turns out :). In addition, briefly on therapy with available antidotes:

Methanol / ethylene glycol poisoning (antifreeze)

The specific antidote for methanol is ethyl alcohol. Given the slow metabolism of methanol, ethanol is taken within 5 days from the moment of methanol consumption. Dose of ethanol: 1 – 2 g / kg of body weight per day. The most optimal concentration of ethanol in the blood is 1 ‰. Ethanol is administered either intravenously by drip (in the absence of consciousness, or vomiting) in the form of a 5% solution (20 ml of 96% solution per 400 ml of 5% glucose solution) at a rate of 100-150 mg / kg / hour or orally as a 30% solution every 3 hours, while the daily dose is evenly distributed between doses. To accelerate the metabolism of formic acid, folic acid is administered at a dose of 50-100 mg 4-6 times a day. With ethylene glycol poisoning, the actions are the same. At the first opportunity – immediately to the hospital with a description of the manipulations performed.

ADDITION: After a small FAQ on the definition of methanol to dot the i

Q : Can pure methanol be distinguished from pure ethanol by smell?
A : Possible, but very difficult. The method does not work in the case of a mixture of methanol + ethanol

Q : Are there chemical methods to distinguish methanol from ethanol.
A : Pure – yes, eg iodoform test: formation of a yellowish precipitate of iodoform when exposed to alcohol with iodine and alkali (sensitivity >= 0.05%).

C ₂ H ₅ OH + 6NaOH + 4I ₂ => CHI ₃ +HCOONa + 5NaI + H ₂ O

Add Lugol’s solution to the alcohol under test, stir and add alkali solution (NaOH) drop by drop. In the case of ethanol, the solution first becomes discolored and then cloudy, a yellow suspension of iodoform is formed, and at high concentrations of alcohol a yellow precipitate forms. Methanol does not give such a reaction.

The second option may be the oxidation of alcohol with copper oxide. A copper wire rubbed to a shine is calcined in a burner flame until blackened, then dipped into the alcohol under study. In the case of methanol, the reaction proceeds:

CH ₃ OH + CuO => H ₂ C=O + Cu + H ₂ O (formaldehyde is formed and the wire becomes shiny) 4 2 H ₅ OH+CuO=>CH ₃ -CH=O + Cu + H ₂ O (acetaldehyde is formed and the wire becomes shiny)

reminds someone of the smell of rotten apples, someone has a strong smell of fumes, formaldehyde – irritates the nasal mucosa, a very pungent smell that can be smelled, for example, when phenol-formaldehyde resin decomposes).

The sad thing is that the mentioned methods are not applicable in the case of an ethanol-methanol mixture. The old laboratory method of determination is the reaction of oxidation of a mixture of alcohols with potassium permanganate in the presence of phosphoric acid and the indication of the formed formaldehyde with chromotropic acid. Reaction proceeds:

5CH ₃ OH + 3H ₃ PO ₄ + 2KMnO ₄ => 5HCOH + 2MnHPO ₄ + K 9 0304 2 HPO ₄ + 8H ₂ O

Formaldehyde formed from methanol gives a violet color with chromotropic acid. Acetaldehyde does not interfere with the reaction.

Old GOST 5964-93 recommends the following method:

GOST 5964-93 method

There are no other “express” options (if it is pressed, it is better to carry it to the chromatograph). So in case there is no desire to understand, it is better to pour such a mixture or burn it. If the volumes of the mixture are serious, the mixture can be separated by distillation (the temperatures are seriously different + methanol does not form azeotropes with water). The boiling point of methanol is 64.7 ° C, and ethanol – 78.39 ° C (78.15 ° C for rectified alcohol containing at least 4.43% water).

Also, if you have a reasonably accurate handheld refractometer:

and knowing the exact concentrations of alcohol, methanol from ethanol can be tried to be distinguished by the refractive index, for methanol nD ²⁰ 1.3288, for ethanol nD ²⁰ 1.3611

Paracetamol poisoning 901 71

Use in the first 16 hours of acetylcysteine ​​( mukomist, mucosolvin). The initial dose of acetylcysteine ​​is 140 mg / kg orally, then 70 mg / kg every 4 hours for 3 days (another 17 doses). The antidote can also be administered intravenously (in particular, with severe vomiting), however, the oral route is more effective and is associated with fewer side effects.

Iron poisoning

The antidote is the chelating agent desferal administered intravenously or
intramuscularly. In patients with initial manifestations of toxicity (50-60 mcg / l of iron in plasma) – the introduction of 10-15 mg / kg / hour of desferal. High doses – 40-50 mg/kg/h are used
only for severe poisoning. The introduction of deferoxamine continues until the level of iron in the blood plasma decreases below 35 μg / l. Do not use in case of pregnant women with acute overdose of iron preparations.

Iodine poisoning

Sodium thiosulfate 30% solution – up to 300 ml per day intravenously, 10% sodium chloride solution 30 ml intravenously.

Poisoning with potassium permanganate (potassium permanganate)

With severe cyanosis (methemoglobinemia) – methylene blue 50 ml of 1% solution, ascorbic acid – 30 ml of 5% solution intravenously.

Copper poisoning

Unithiol – 10 ml of 5% solution, then 5 ml every 3 hours intramuscularly for 3-5 days. Sodium thiosulfate – 100 ml of a 30% solution intravenously.

Lead poisoning

Tetacin-calcium (CaEDTA) at a dose of 50 mg/kg/day) divided into 3-4 intramuscular doses. Unitiol 5-10 ml of 5% solution intramuscularly 4 times a day for 5 days. Oral DMSA (succimer) 10 mg/kg every 8 hours for 5 days or every 12 hours for 14 days.

Poisoning with poisonous mushrooms with hepatotropic poisons (Amatoxins) – pale grebe,
toadstool, smelly fly agaric

Penicillin 1 million U/kg/day. Silibinin (legalon) – 20 mg / kg / day. When using preparations containing silymarin (silibor, carsil), it should be remembered that 70 mg of silymarin approximately corresponds in effectiveness to 30 mg of silibinin.

Disulfiram poisoning , a drug used in the treatment of alcoholism. Relevant for those who have fallen

Intravenous administration of 40% glucose solution – 40 ml with 5% ascorbic acid solution – 10 ml. Sodium bicarbonate – 4% solution 200 ml – intravenous drip. Vitamin B 1 – 5% solution – 2 ml intramuscularly.

Poisoning by nitrites/nitrates, benzene, aniline, nitrogen oxides and other methemoglobin formers.

1% methylene blue 0.1-0.2 ml/kg (1-2 mg/kg) with 5% glucose 200-300 ml IV, repeated if necessary after 15-20 minutes.