Specific antidotes

a. Organochlorine poisoning:

• The patient is induced to vomiting and given universal antidotes; the patient can be given phenol-barbital @ 0.7 gm/day.
• If not recovered 10% calcium gluconate injection (10 cc) is administered intravenously. The patient should be given a carbohydrate-containing diet to check for liver damage.

b. Organophosphate poisoning:

• The patient is allowed to induce vomiting, administered artificial, respiration, and atropine sulfate is given intravenously.
• Protopam chloride (2 PAM) is administered to reactivate cholinesterase and other antidotes such as morphine, epinephrine, or barbiturate are never used.

c. Carbamate poisoning:

• After induced vomiting, the patient is given Atropine sulfate 2 mg intravenously and then repeated after 5-10 minutes intervals. 2-PAM is not effective as it cannot decarboxylate the inhibited ache.
• Drugs like epinephrine are not given as heart muscles become sensitive.

d. Nicotine poisoning:

• Universal antidote and gastric lavage should be from the earliest part of treatment.
• Potassium permanganate (1:10,000) can be used in lavage fluid to inactivate the alkaloids. Intravenous Diazepam therapy may be required to bring to sedation if the victim exhibits convulsions.
• Patients surviving more than a few hours are likely to recover since nicotine is fairly metabolized rapidly to fewer toxic metabolites.

e. Arsenical poisoning:

• Universal antidote and gastric lavage are commonly followed in arsenical poisoning.
• The patient is given 225 gm of sodium bicarbonate, and  28 gm of magnesium sulfate (Epsom) diluted in one liter of water.
• The poisoning may be cheated by BAL (dimercaprol) given intravenously.

f. Zinc phosphide poisoning:

• The victim is allowed to vomit by drinking a glass of warm water with one teaspoonful of mustard powder.
• After the vomiting has stopped, he is given five grams of potassium permanganate dissolved in a glass of warm water.
• Ten minutes later a teaspoonful of copper sulfate in a glass of water is given.
• After fifteen minutes this is followed by one teaspoonful of magnesium sulfate (Epson) in a glass of water.