Targeted therapies

• Activated charcoal

• Deferoxamine mesylate inj

• Digoxin immune fab inj

• Fomepizole inj

• Methylene blue 0.5% in

• Pyridoxine inj

Priority 2 (Immediate access/lifesving/single victim) antidotes for targeted therapies

General poisoning / overdose

Activated charcoal indication

Iron poisoning

Deferoxamine mesylate inj indication

Cardiac glycoside/steroid poisoning

Digoxin immune fab inj indication

Ethylene glycol, methanol toxicity

Fomepizole inj indication

Methemoglobinemia

Methylene blue 0.5% inj indication

• Isoniazid, Hydrazine, MAOI toxicity

Pyridoxine inj indication

Activated charcoal PO

All priority 2 antidotes for targeted therapies are administered IV, except this drug

Fomepizole inj

All priority 2 antidotes for targeted therapies are in order set or clinical protocols, except this drug

Digoxin immune fab inj

This drug Mimimum adequate to treat one patient

• Atropine sulfate inj 1

• Flumazenil inj 2

• Naloxone inj 2

• Phentolamine 3

Reversa agents for targeted therapies with tier

Nerve agents, organophosphate toxicity

Atropine sulfate inj indication

Benzodiazepines, zaleplon, zolpidem toxicity

Flumazenil inj indication

• Opioid overdose

• Unknown poisoning with mental status depression

Naloxone inj indication

• Extravasation of vasopressor/vasoacve agents

Phentolamine indication

IV

Atropine sulfate in and flumazenil inj route

• IV

• IM

• IN

Naloxone inj route

Infiltration

Phentolamine route

• Dantrolene inj (Ryanodex)

• Glucagon inj

• Lipid 20% emulsion inj

Rescue agents priority 2 for targeted therapies

l-carnitine inj

Rescue agents priority 4 for targeted therapies

Malignant hyperthermia

Dantrolene inj indication

BB/CCB toxicity or hypoglycemia

Glucagon inj indication

Valproate induced hyperammonemia or hepatic dysfunction

L-carnitine inj

Highly lipophilic drug overdose induced cardiac arrest (LAST)

Lipid 20% emulsion inj

• Hyaluronidase

• N-acetylcysteine 20% inj (Acetadote)

• N-acetylcysteine oral (Mucomyst)

• Physostigmine inj

Priority 3 antidote for targeted therapies

Extravasation

Hyaluronidase indication

Acetaminophen overdose

N-acetylcysteine indication

Atropine and anticholinergic agents

Physostigmine indication

IV

What route are rescue agents administered

Phentolamine

What reversal agent recommends an order set or clinical protocol

• Hydroxocobalamin inj (Cyanokit)

• Pralidoxime inj

• Sodium nitrite/sodium thiosulfate

Priority 1 antidote for targeted therapies

• Cyanide poisoning

• Inhalation injury

Hydroxocobalamin inj (Cyanokit) indication

• Cyanide poisoning

• Inhalation injury

Sodium nitrite/sodium thiosulfate (Cyanokit) indication

Nerve agents, organophosphate toxicity

Pralidoxime inj indication

Sodium thiosulfate/sodium nitrite

Alternative agent for use during hydroxocobalamin shortage; 2component kit (stock 2 kits)

• ID

• SC

Hyaluronidase route

• IM

• IV

Physostigmine route

Pralidoxime inj IV, IM

All priorit 1 antidote for targeted therapies are administered via IV, except for this drug

Leucovorin IV

Antidote/ rescue agents priority 4 for targeted therapies

• Methotrexate

• methanol

LEUCOVORIN INDICAITON