Medication Summary
Medical care of poisoning is primarily symptomatic in nature. Gastric decontamination may benefit by reducing the absorbed dose.
GI decontaminants
Class Summary
These agents are the preferred method when GI decontamination is desired. They are generally mixed and given with a cathartic (eg, 70% sorbitol), except in young pediatric patients in whom electrolyte disturbances may be of concern.
Activated charcoal (Liqui-Char)
Emergency treatment in poisoning caused by drugs and chemicals. Network of pores present in activated charcoal adsorbs 100-1000 mg of drug per gram of charcoal. Does not dissolve in water.
For maximum effect, administer within 30 min of ingesting poison.
Antihistamines
Class Summary
Competitive histamine antagonists minimize severity of hypersensitivity response.
Diphenhydramine (Benadryl)
For symptomatic relief of symptoms caused by release of histamine in allergic reactions.
Hydroxyzine (Vistaril, Atarax)
Antagonizes H1 receptors in periphery. May suppress histamine activity in subcortical region of CNS. Sedating, alternative to diphenhydramine.
Benzodiazepines
Class Summary
These agents are used to abort seizures, if present.
Diazepam (Valium)
Depresses all levels of CNS (eg, limbic and reticular formation), possibly by increasing activity of GABA.
Lorazepam (Ativan)
Sedative hypnotic with short onset of effects and relatively long half-life.
By increasing the action of GABA, which is a major inhibitory neurotransmitter in the brain, may depress all levels of CNS, including limbic and reticular formation.
Monitoring patient's blood pressure after administering dose is important. Adjust prn.
Corticosteroids
Class Summary
These agents are useful for contact dermatitis.
Prednisone (Deltasone)
May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.
Methylprednisolone (Solu-Medrol, Depo-Medrol)
Useful to treat inflammatory and allergic reactions. By reversing increased capillary permeability and suppressing PMN activity, may decrease inflammation.
Multiple corticosteroid preparations are available. Widely available in the ED because of its other uses (ie, acute asthma, spinal cord injury) and is supplied in both parenteral and oral formulations and is therefore discussed here as a typical drug of this class.
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