Comments on: What antidotes should my hospital stock? http://www.thepoisonreview.com/2009/12/15/what-antidotes-should-my-hospital-stock/ "Poison is everything and no thing is without poison" - Paracelsus Sat, 28 Jan 2012 22:47:06 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Leon http://www.thepoisonreview.com/2009/12/15/what-antidotes-should-my-hospital-stock/comment-page-1/#comment-84 Leon Thu, 17 Dec 2009 04:14:06 +0000 http://www.thepoisonreview.com/?p=437#comment-84 Potassium Iodide: that's an excellent point. Unfortunately, the paper. Unfortunately, the paper did not give detailed explanations for all their decisions, including that concerning KI. Perhaps they envisioned a situation where a radioactive iodine release at a nearby facility might send people flocking to the ED, even before actual exposure. In that case, it's difficult to see why they recommended stocking only a single adult dose, especially since KI is so inexpensive. Mycyk: I think the panel probably realized the obvious -- if you have enough antidote available to treat only a single 70-kg patient, you'll end up underdosing a large part of the population. Potassium Iodide: that’s an excellent point. Unfortunately, the paper. Unfortunately, the paper did not give detailed explanations for all their decisions, including that concerning KI. Perhaps they envisioned a situation where a radioactive iodine release at a nearby facility might send people flocking to the ED, even before actual exposure. In that case, it’s difficult to see why they recommended stocking only a single adult dose, especially since KI is so inexpensive.

Mycyk: I think the panel probably realized the obvious — if you have enough antidote available to treat only a single 70-kg patient, you’ll end up underdosing a large part of the population.

]]> By: Mycyk http://www.thepoisonreview.com/2009/12/15/what-antidotes-should-my-hospital-stock/comment-page-1/#comment-83 Mycyk Wed, 16 Dec 2009 19:43:34 +0000 http://www.thepoisonreview.com/?p=437#comment-83 Yes, I agree, essential 5-star (skull) reading for all clinicians. A terrific update of their earlier paper. I especially appreciate the use of a 100kg patient for their recommendations -- it shows this expert panel is really in touch with clinical reality in the 21st Century. Yes, I agree, essential 5-star (skull) reading for all clinicians. A terrific update of their earlier paper. I especially appreciate the use of a 100kg patient for their recommendations — it shows this expert panel is really in touch with clinical reality in the 21st Century.

]]> By: Potassium Iodide http://www.thepoisonreview.com/2009/12/15/what-antidotes-should-my-hospital-stock/comment-page-1/#comment-82 Potassium Iodide Wed, 16 Dec 2009 18:40:28 +0000 http://www.thepoisonreview.com/?p=437#comment-82 potassium iodide is not an antidote as it is to be taken prior to exposure. However, it should be stocked by every hospital. potassium iodide is not an antidote as it is to be taken prior to exposure. However, it should be stocked by every hospital.

]]> By: Leon http://www.thepoisonreview.com/2009/12/15/what-antidotes-should-my-hospital-stock/comment-page-1/#comment-81 Leon Wed, 16 Dec 2009 05:59:21 +0000 http://www.thepoisonreview.com/?p=437#comment-81 Chris: I'd agree that having 8 hours worth of glucagon on hand might be a bit much considering the price. Having enough to treat for an hour or two might come in handy for the severe beta-blocker overdose, especially if reliable agreements to get some more fast can be worked out with nearby hospitals. Insulin/glucose is a must -- the authors might not have mentioned it because they assumed it would be available in any case. I also look forward to seeing what the future holds for intralipid. While in my opinion it's not yet ready for prime time as first-line treatment, the experience so far looks good, especially in the crashing tox patient with cardiovascular instability that is not responding to standard therapy. Chris:

I’d agree that having 8 hours worth of glucagon on hand might be a bit much considering the price. Having enough to treat for an hour or two might come in handy for the severe beta-blocker overdose, especially if reliable agreements to get some more fast can be worked out with nearby hospitals. Insulin/glucose is a must — the authors might not have mentioned it because they assumed it would be available in any case.

I also look forward to seeing what the future holds for intralipid. While in my opinion it’s not yet ready for prime time as first-line treatment, the experience so far looks good, especially in the crashing tox patient with cardiovascular instability that is not responding to standard therapy.

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