Poisoning And Antidotes In Children
some useful important poisioning in children , and antidotes of them,
1. | Amphetamines Poisoning (Toxic dose 50mg) | Chlorpromazine 1mg/kg I.M. or IV. |
Treatment should be started if ingestion is >2mg | ||
2. | Anticholinergics Poisoning | Give physostigmine 0.02mg/kg/dose, |
(eg. Atropine, belladonna) | upto max. 2mg LV., S.C. or I.M. till desired | |
effect is observed. | ||
3. | Benzodiazepines Poisoning | Give flumazenil in incremental doses of 0.1 mg, 0.2mg, 0.3mg, |
O.Smg LV. at 1 minute intervals until the desired effect is observed | ||
4. | Cyanide Poisoning | Amylnitrite inhalation for 30 seconds |
(Lethal dose 200-300mg) | every minute and use a new pearl every | |
3 minutes till LV. access and sodium nitrite infusion is available. | ||
Give sodium nitrite 3% solution, 0.2-0.4ml/kg, infused IV over | ||
absolutely no less than S minutes, then infuse sodium thiosulphate | ||
1–2ml/kg (max. SOml) of 2S% solution over 10 minutes. Average | ||
paediatric dose of amyl nitrite is 0.12-0.33mVkg upto 1 Oml, infused | ||
as above. | ||
S. | Heparin Poisoning | Protamine sulphate 2.S–S.0mg/kg loading dose followed by 1- |
2.Smg/kg LV. every 4 hrly, to be given slowly over S minute. | ||
6. | Methyl alcohol Poisoning | 10ml/kg of 10% solution of ethyl alcohol LV. as loading dose and |
then 1.Sml/kg/hr. infusion. | ||
Oral: 1 mVkg of 9S% ethyl alcohol in fruit juice over 30minutes | ||
and then 0.lS-0.3mVkg/hr as SO% ethyl alcohol in fruit juice. | ||
7. | Morphine and Other opiates Poisoning | Naloxane O.lmg/kg/dose LV., Max. dose |
in children is 2mg. | ||
8. | Organophosphorus poisoning | Do adequate atropinization by atropine |
O.OSmg/kg/I.V. every S-10min, until secretions are dried. | ||
Give PAM (Pralidoxime); 2S–S0mg/kg diluted to S% in normal | ||
saline and infused over S-30minutes. May be repeated after 1 hr. | ||
and then 6-12hriy. | ||
9. | Phenothiazine and Metoclopramine Poisoning | Diphenhydramine 1-2mg/kg I. V. every |
(Extrapyramidal effects) | 30min, may be repeated after 3-4hr. I.M. | |
or PO. Max 300mg/day. | ||
10. | Propranolol (b-blockers) Poisoning | Do atropinization by atropine 0.1-0.2mglkg/dose S.C. and maintain |
for 1 day and then taper in the next 24hr. Then infuse SO-lS0 | ||
mco/ko of olucaoons bolus followed by SOmcg/kg/hr. | ||
11. | Warfarin Poisoning | Vii K S-10mg I.M. or LV. |