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.