Ricin Exposure Medication

Updated: May 04, 2017
  • Author: Ferdinando L Mirarchi, DO, FAAEM, FACEP; Chief Editor: Zygmunt F Dembek, PhD, MPH, MS, LHD  more...
  • Print
Medication

Medication Summary

Tetanus status should be updated if unknown. If exposure is via the parenteral route, antibiotics may be helpful in preventing secondary bacterial infection.

Next:

Antibiotics, Other

Class Summary

With regard to ricin toxicity, the only possible indication for antibiotics is for the parenteral mechanism of exposure. Direct the choice of antibiotic to cover skin flora.

Cefazolin

Cefazolin is a first-generation semisynthetic cephalosporin that arrests bacterial cell wall synthesis, inhibiting bacterial growth.

Previous
Next:

Alpha/Beta Adrenergic Agonists

Class Summary

Before or simultaneously with the use of vasopressors, perform adequate volume resuscitation of patients with isotonic fluids and packed red blood cells; do not use these agents in place of volume resuscitation. The choice of agent is usually determined by physician preference. There is no criterion standard vasopressor for treatment of hypotension caused by ricin toxicity.

Dopamine

Dopamine is probably the best-known and most widely used pressor agent. A standard mixture of 200 mg in 250 mL produces a concentration of 800 µg/mL; administer intravenously (IV).

Norepinephrine (Levophed)

Norepinephrine is often a second-line agent but can be used as a first-line agent. It can be given with dopamine. A standard mixture of 4 mg in 250 mL produces a concentration of 16 µg/mL; administer IV.

Previous
Next:

Vaccine, Inactivated (Bacterial)

Class Summary

Toxoids are used to induce active immunity. Tetanus status should be updated if unknown.

Diphtheria and tetanus toxoid (Tenivac)

Diphtheria and tetanus toxoid is used to induce active immunity against tetanus in selected patients.

Previous
Next:

Antidotes, Other

Class Summary

Antidotes are used to inhibit or reduce absorption of the toxin.

Activated charcoal (CharcoCaps, EZ-Char, Actidose Aqua)

Activated charcoal is employed as a component of emergency treatment in poisoning caused by drugs and chemicals. The network of pores present in activated charcoal adsorbs 100-1000 mg of drug per gram of charcoal. Charcoal does not dissolve in water. For maximum effect, it should be administered within 30 minutes after the ingestion of the poison.

Previous