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Journal of Intensive Care Medicine
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Antidote Use in the Critically Ill Poisoned Patient

David P. Betten, MD

Department of Emergency Medicine, Sparrow Health System, Michigan State University College of Human Medicine, Lansing, Michigan, peckb73{at}hotmail.com

Rais B. Vohra, MD

University of California, San Diego, California Poison Control System, San Diego, California

Matthew D. Cook, DO

University of California, San Diego, California Poison Control System, San Diego, California

Michael J. Matteucci, MD

Department of Emergency Medicine, Naval Medical Center, San Diego, California

Richard F. Clark, MD

University of California, San Diego, California Poison Control System, San Diego, California

The proper use of antidotes in the intensive care setting when combined with appropriate general supportive care may reduce the morbidity and mortality associated with severe poisonings. The more commonly used antidotes that may be encountered in the intensive care unit (N-acetylcysteine, ethanol, fomepizole, physostigmine, naloxone, flumazenil, sodium bicarbonate, octreotide, pyridoxine, cyanide antidote kit, pralidoxime, atropine, digoxin immune Fab, glucagon, calcium gluconate and chloride, deferoxamine, phytonadione, botulism antitoxin, methylene blue, and Crotaline snake antivenom) are reviewed. Proper indications for their use and knowledge of the possible adverse effects accompanying antidotal therapy will allow the physician to appropriately manage the severely poisoned patient.

Key Words: antidote • poisoning • overdose

Journal of Intensive Care Medicine, Vol. 21, No. 5, 255-277 (2006)
DOI: 10.1177/0885066606290386
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