Side effects of mucomyst. Mucomyst Side Effects: Understanding Common, Severe, and Long-Term Reactions
What are the common side effects of Mucomyst. How can severe reactions be identified. What long-term effects should patients be aware of. How does Mucomyst interact with other medications. When should a doctor be consulted about Mucomyst side effects.
What is Mucomyst and How Does It Work?
Mucomyst, also known by its generic name acetylcysteine, is a medication used for various purposes in the medical field. Its primary functions include:
- Thinning and loosening mucus in the airways for patients with certain lung diseases
- Preventing liver damage from acetaminophen overdose when taken orally
When inhaled, Mucomyst helps patients with conditions such as emphysema, bronchitis, cystic fibrosis, and pneumonia to breathe more easily by clearing mucus from their lungs. The medication works by breaking down the molecular bonds in mucus, making it less viscous and easier to expel.
For acetaminophen overdose cases, oral administration of Mucomyst can help protect the liver from potential damage. It acts as an antidote by replenishing glutathione, a crucial compound that helps detoxify harmful substances in the liver.
Common Side Effects of Mucomyst: What to Expect
While Mucomyst is generally well-tolerated, some patients may experience side effects. The most common side effects include:
- Nausea
- Vomiting
- Mouth sores (when inhaled)
- Runny nose (when inhaled)
These side effects are usually mild and may subside as the body adjusts to the medication. However, if these symptoms persist or worsen, it’s important to consult a healthcare provider.
Can the taste of Mucomyst cause discomfort? Some patients report a slight odor when first inhaling the medication, but this typically dissipates quickly. To minimize any unpleasant taste when taking Mucomyst orally, it’s often mixed with other liquids such as cola.
Recognizing Severe Side Effects: When to Seek Medical Attention
While rare, some patients may experience severe side effects that require immediate medical attention. These include:
- Severe stomach or abdominal pain
- Black stools
- Vomit that resembles coffee grounds
- Chest pain or tightness
- Difficulty breathing
These symptoms could indicate serious conditions such as gastrointestinal bleeding or severe allergic reactions. If any of these occur, it’s crucial to seek medical help immediately.
How can patients distinguish between normal side effects and severe reactions? Normal side effects are typically mild and improve over time, while severe reactions are often sudden, intense, and may be accompanied by other symptoms like dizziness or swelling.
Long-Term Effects of Mucomyst: What We Know
The long-term effects of Mucomyst use are not extensively documented, as the medication is often used for short periods or in emergency situations. However, some considerations for prolonged use include:
- Potential impact on liver function tests
- Possible changes in mucus production and consistency
- Monitoring for rare but serious side effects
Patients using Mucomyst for extended periods should maintain regular check-ups with their healthcare provider to monitor for any potential long-term effects.
Are there any known cumulative effects of long-term Mucomyst use? While research is limited, there’s no strong evidence suggesting significant cumulative effects from long-term use when the medication is taken as prescribed.
Mucomyst Interactions: Navigating Potential Risks
Understanding drug interactions is crucial for patient safety. Mucomyst may interact with various medications and substances, including:
- Certain antibiotics
- Activated charcoal
- Nitroglycerine
These interactions can affect how Mucomyst works or increase the risk of side effects. It’s essential for patients to inform their healthcare providers about all medications, supplements, and herbal products they’re taking.
How does Mucomyst affect laboratory tests? The medication may interfere with certain lab tests, particularly urine ketone tests, potentially causing false results. Patients should inform laboratory personnel and their doctors about their Mucomyst use to ensure accurate test interpretation.
Special Precautions: Who Should Exercise Caution with Mucomyst?
Certain groups of patients should use Mucomyst with caution or under close medical supervision:
- Individuals with asthma
- Patients with stomach or intestinal ulcers
- Pregnant women
- Breastfeeding mothers
For these groups, the potential benefits of Mucomyst must be carefully weighed against the risks. Healthcare providers may need to adjust dosages or consider alternative treatments.
Is Mucomyst safe for use during pregnancy? While Mucomyst should only be used during pregnancy when clearly necessary, healthcare providers may prescribe it if the potential benefits outweigh the risks. Pregnant women should discuss their individual situations with their doctors.
Proper Usage and Administration of Mucomyst
Correct administration of Mucomyst is crucial for its effectiveness and safety. The method of administration depends on the condition being treated:
- For lung conditions:
- Inhaled by mouth using a nebulizer
- Follow instructions provided by a healthcare professional
- Do not mix with other inhaled medications unless directed
- For acetaminophen overdose:
- Taken orally, often mixed with another liquid
- Consume within 1 hour of mixing
- Dosage based on weight and severity of overdose
Patients should always follow their healthcare provider’s instructions and the medication’s guidelines for proper usage.
What should patients do if they miss a dose of Mucomyst? For inhaled Mucomyst, take the missed dose as soon as remembered, unless it’s close to the time for the next dose. For oral Mucomyst in overdose treatment, contact a healthcare provider immediately for guidance.
Managing Side Effects: Tips for Mucomyst Users
While side effects can be uncomfortable, there are strategies to manage them effectively:
- For nausea: Take Mucomyst with food or as directed by a healthcare provider
- For mouth sores: Rinse mouth with water after inhaling the medication
- For skin irritation: Wash face with water after using a face mask for inhalation
- For unpleasant taste: Mix oral Mucomyst with recommended liquids to improve palatability
If side effects persist or worsen, it’s important to consult a healthcare provider. They may adjust the dosage or recommend alternative treatments.
Can lifestyle changes help minimize Mucomyst side effects? While not extensively studied, maintaining good hydration, following a balanced diet, and avoiding irritants like smoke may help some patients better tolerate the medication.
Monitoring and Follow-up: Ensuring Safe Long-term Use
For patients using Mucomyst over extended periods, regular monitoring is essential. This may include:
- Periodic liver function tests
- Assessment of respiratory function for those using inhaled Mucomyst
- Regular check-ups to evaluate the medication’s effectiveness and any potential side effects
Healthcare providers may adjust treatment plans based on these assessments to ensure optimal outcomes and minimize risks.
How often should patients using Mucomyst long-term have follow-up appointments? The frequency of follow-ups can vary depending on the individual’s condition and response to treatment. Generally, patients might expect check-ups every 3-6 months, but this can be more or less frequent based on their healthcare provider’s recommendation.
Alternative Treatments: Exploring Options Beyond Mucomyst
While Mucomyst is effective for many patients, some may seek alternatives due to side effects or other concerns. Potential alternatives include:
- Other mucolytic agents
- Bronchodilators
- Chest physiotherapy
- Hydration therapy
The appropriateness of these alternatives depends on the specific condition being treated and should be discussed with a healthcare provider.
Are there natural alternatives to Mucomyst for mucus thinning? While not as potent as Mucomyst, some natural remedies like staying hydrated, using a humidifier, and consuming warm liquids may help thin mucus. However, these should not replace prescribed treatments without medical advice.
Patient Education: Empowering Mucomyst Users
Educating patients about Mucomyst is crucial for safe and effective use. Key points to emphasize include:
- Proper administration techniques
- Recognition of side effects and when to seek medical attention
- Importance of adherence to prescribed dosage and schedule
- Potential interactions with other medications and substances
Healthcare providers should ensure patients understand these aspects and feel comfortable asking questions about their treatment.
How can patients stay informed about new developments regarding Mucomyst? Patients can stay updated by regularly consulting with their healthcare providers, following reputable medical news sources, and checking for updates from health organizations like the FDA or EMA.
Overdose Risks: Understanding and Preventing Complications
While Mucomyst is generally safe when used as directed, overdose is possible and can be dangerous. Symptoms of overdose may include:
- Severe nausea and vomiting
- Difficulty breathing
- Loss of consciousness
If an overdose is suspected, immediate medical attention is crucial. In the US, contact the local poison control center at 1-800-222-1222 or call 911 for severe symptoms.
What steps can patients take to prevent accidental overdose of Mucomyst? To prevent overdose, patients should carefully follow prescribed dosages, use appropriate measuring devices for liquid formulations, and store the medication safely out of reach of children.
Future Research: Expanding Our Understanding of Mucomyst
Ongoing research into Mucomyst aims to expand its applications and improve its safety profile. Areas of current interest include:
- Potential use in treating other respiratory conditions
- Development of new formulations for easier administration
- Long-term effects of prolonged use
- Combination therapies with other medications
These studies may lead to new treatment options and improved patient outcomes in the future.
How might future developments in Mucomyst research benefit patients? Advancements could potentially lead to more targeted treatments, reduced side effects, and expanded applications for Mucomyst, ultimately improving quality of life for patients with various respiratory and liver conditions.
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
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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.