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Food Interactions, Sirtuins, Genes, Homeostasis, and General Discussion
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Antagonism is the opposite of synergism. It is the situation where the combined effect of two or more compounds gives less effects than the individual effects; for example, 5 + 10 < 15. Antagonistic effects are the basis of many antidotes for poisonings or for medical treatments (1).
Trauma and Poisoning
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Therapy for poisoning by a specific agent may include the use of an antidote (literally, "to give against"). An antidote counteracts a specific poison, either inactivating it, facilitating its elimination, or blocking its activity. Activated charcoal was formerly administered in combination with magnesium oxide and tannic acid in what was called the "universal antidote"; the usefulness of the combination, however, is questionable and it is seldom used any longer.
Therapeutic Monitoring of Adverse Drug Reactions (ADRs)
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
5. Administration of an antidote. As noted earlier, adherence to the ABC principles and good supportive care are the hallmarks of treatment of the poisoned patient. Once the agent responsible is suspected or identified, the administration of an antidote may be necessary. Table 3.11 organizes a variety of toxins according to their classification and available antidotes. Although only a small number of antidotes are available, many of these agents can completely reverse the toxicologic consequences of poisoning. Also, specific antidotes are discussed further under the individual chapter headings (chelating agents for metal poisoning are reviewed separately in Chapter 24, Metals). However, it should be noted that antidotes are associated with their own adverse reactions and toxicity. In addition, the effectiveness of antidotes is compromised in the presence of overdose from multiple agents.
Evaluation of aqueous dimethyl trisulfide as an antidote to a highly lethal cyanide poisoning in a large swine model
Published in Clinical Toxicology, 2022
Tara B. Hendry-Hofer, Carter C. Severance, Subrata Bhadra, Patrick C. Ng, Kirsten Soules, Dennean S. Lippner, Diane M. Hildenberger, Melissa O. Rhoomes, Jessica N. Winborn, Brian A. Logue, Gary A. Rockwood, Vikhyat S. Bebarta
Although current FDA-approved therapies hydroxocobalamin (Cyanokit®) and sodium nitrite/sodium thiosulfate (Nithiodote®) are efficacious, they require intravenous administration [7,8]. Moreover, hydroxocobalamin requires reconstitution and both antidotes require slow intravenous infusion, limiting their usefulness when rapid administration of antidote to a large number of victims in a short period of time is necessary. Furthermore, these antidotes are expensive making it costly to maintain a stockpile in case of a mass exposure. Lastly, following administration of these antidotes, patients require careful monitoring for adverse effects such as hypotension, hypertension, cardiac arrhythmias, tachycardia, nausea, vomiting, and methemoglobinemia. With the high risk of a large-scale cyanide exposure resulting in multiple critically ill victims, an efficacious antidote with minimal side effects that is quick and easy to administer is needed. Intramuscular administration (IM) of dimethyl trisulfide (DMTS) has been evaluated in rodent and large animal models and found to be efficacious against lethal cyanide poisoning [9–11]. However, with the exception of the study done by Rice and colleagues [11], the majority of these studies have not evaluated long-term efficacy of DMTS. Additionally, these studies were done using a previous formulation of DMTS, whereas this study was completed using a new, novel, aqueous formulation of DMTS that has improved bioavailability and demonstrates efficacy at a much lower dose [10,12].
Cardiopulmonary resuscitation in poorly resourced settings: better to pre-empt than to wait until it is too late
Published in Paediatrics and International Child Health, 2020
There are always some exceptions to rules and likelihoods and one is drug overdose. If a child has taken a toxic dose of, for example, an opiate, anxiolytic or anti-epileptic, every attempt should be made to continue resuscitation until the drug effect has passed. Some drugs have an antidote which will hasten recovery and reverse some of the toxic effects of drugs. Another exception is drowning in very cold water. This is unlikely in hot climates but, should such an accident occur, slow warming and continued resuscitation over time are appropriate. However, in a study of 160 Dutch children <16 years old with cardiac arrest and hypothermia after drowning during 1993–2012, 98 (61%) required >30 min of CPR and 87 (89%) died. The 11 survivors were all neurologically damaged whereas, of the 62 (39%) who required CPR for <30 min, 17 survived, 10 were neurologically normal, 5 had mild disabilities and 2 had moderate disabilities [32].
Mass spectrometry in emergency toxicology: Current state and future applications
Published in Critical Reviews in Clinical Laboratory Sciences, 2019
Xander M. R. Van Wijk, Robert Goodnough, Jennifer M. Colby
Emergency toxicology does just this, and is centered around the diagnosis and management of the critically poisoned patient. Care of poisoned patients often starts with the “ABCs” of resuscitation (airway, breathing, and circulation), vital signs, and, where possible, identification of a specific toxic syndrome (toxidrome) [3,4]. Treatment is largely supportive and may include measures to limit absorption of the poison, e.g. gastric emptying or use of activated charcoal, or to enhance excretion, e.g. urine alkalization in salicylate overdose or hemodialysis [4]. Some poisons have specific antidotes that can be administered. For example, naloxone can be used to reverse an opioid overdose. Of note, naloxone use reported to US poison centers has almost tripled from 2000 to 2016 [5]. Other well-known examples of specific antidotes are N-acetylcysteine for acetaminophen and digoxin-specific antibody fragments for digoxin and other cardiac glycosides [4].