Medication Summary
No specific antidotal drug therapy for toluene poisoning exists. Toluene is not significantly adsorbed by activated charcoal.
Presently, inhaled beta-agonists and steroid therapy should be considered first-line agents for patients presenting with asthma and respiratory symptoms.
Cardiovascular Agent
Class Summary
These agents may be used to convert an inhalant-induced dysrhythmia.
Esmolol
Ultra–short-acting agent that selectively blocks beta1-receptors with little or no effect on beta2-receptor types. Particularly useful in patients with elevated arterial pressure, especially if surgery is planned. Shown to reduce episodes of chest pain and clinical cardiac events compared to placebo. Can be discontinued abruptly if necessary. Useful in patients at risk for experiencing complications from beta-blockade; particularly those with reactive airway disease, mild-moderate LV dysfunction, and/or peripheral vascular disease. Short half-life of 8 min allows for titration to desired effect and quick discontinuation if needed.
Propranolol
Class II antiarrhythmic, nonselective beta-adrenergic receptor antagonist with membrane-stabilizing activity that decreases automaticity of contractions.
Effective for treating aggression resulting from head injury. They also are used for reducing restlessness and disinhibition. Treatment for persistent agitation and aggression in organic brain syndromes.
Alkalinizing agents
Class Summary
These agents may be used to raise blood and urinary pH.
Sodium bicarbonate (Neut)
Neutralizes hydrogen ion concentrations and raises blood and urinary pH. Indicated in patients with renal tubular acidosis due to toluene. In patients with severe non–anion gap acidosis, an iInfusion can be prepared with 3 ampules (133.8 mEq or 150 mEq, depending on whether 7.5% or 8.4% ampules are used) of sodium bicarbonate in 1 L of D5W.
