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Evolution of Antidotal Therapy in Recent Decades

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Applied Toxicology: Approaches Through Basic Science

Part of the book series: Archives of Toxicology ((TOXICOLOGY,volume 19))

Abstract

Antidotes are pharmaceuticals intended to counteract the noxious effects of chemicals, either man-made or of natural origin. They may modify the kinetics of a given toxic substance, its absorption or elimination, reduce its effects on the receptors, and, through different modes of action, ameliorate the functional and vital prognosis of poisonings. The IPCS1 definition of “antidote”: “therapeutic substance administered to counteract the adverse effects of a specific xenobiotic”, allows the inclusion of anti-venoms and pharmaceuticals (such as glucose, vitamin K, diazepam, or isoprenaline), widely used in the medical setting but useful too in the management of certain type of poisonings. As in the medical practice antidotes, antagonists, antivenoms and pharmaceuticals are used in conjunction with techniques intended to reduce absorption or enhance elimination of poisons, also treatment procedures are to be considered when evaluating the more specific antidotes.

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References

  • Antman EM, Wenger TL, Butler VP, Haber E, Smith TW (1990) Treatment of 150 cases of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments. Final report of a multicenter study. Circulation 81(6):i744–52.

    Google Scholar 

  • Aposhian HV, Maiorino RM, Gonzalez-Ramirez D, Zuniga-Charles M, Xu Z, Hurlbut KM, Junco-Munoz P, Dart RC, Aposhian MM (1995) Mobilization of heavy metals by newer, therapeutically useful chelating agents. Toxicol 97:23–38.

    Article  Google Scholar 

  • Baud FJ, Barriot P, Toffis V, Riou B, Astier A (1988) Cyanide poisoning in fire victims. Intens. Care Med. 14:S289.

    Google Scholar 

  • Baud FJ, Sabouraud A, Vicaut E et al. (1995) Treatment of severe colchicine overdose with colchicine-specific Fab fragments. N Engl J Med 332:642–645.

    Article  PubMed  CAS  Google Scholar 

  • Besunder JB, Anderson RL, Super DM (1995) Short-term efficacy of oral dimercaptosuccinic acid in children with low to moderate lead intoxication. Pediatr 96:683–687.

    CAS  Google Scholar 

  • Bismuth Ch, Baud FJ, Scherrmann JM (1995) Application humaine de I’mmunothérapie dans I’ntoxication par la colchicine. La Revue du Practicien 9, 291:14–16.

    Google Scholar 

  • Brouard A, Blaisot B, Bismuth C (1987) Hydroxocobalamin in cyanide poisoning. J. Toxicol. Clin. Exp. 7:155–168.

    PubMed  CAS  Google Scholar 

  • Burkhart KK, Kulig KW (1990) The diagnostic utility of flumazenil (a benzodiazepine antagonist) in coma of unknown etiology. Ann Emerg Med 19:319–321.

    Article  PubMed  CAS  Google Scholar 

  • Caravati EM (1988) Acute hydrofluoric acid exposures. Am. J Emerg Med 6:143–150.

    Article  PubMed  CAS  Google Scholar 

  • Consroe P, Egen NB, Russell FE, Gerrish K, Smith DC, Sidki A, Landon JT (1995) Comparison of a new ovine antigen fragment (Fab) antivenin for United States Crotalidae with the commercial antivenin for protection against venom-induced lethality in mice. Am J Trop Med Hyg 53:507–510.

    PubMed  CAS  Google Scholar 

  • Cottrell JE, Casthely P, Brodie JD, Patel K, Klein A, Turndorf H (1982) Prevention of nitroprusside-induced toxicity with hydroxocobalamin. New Engl J. Med, 298:809–811.

    Article  Google Scholar 

  • Cummins RO, Haulman J, Quan L, Graves JR, Peterson D, Horan S (1990) Near fatal yew berry intoxication treated with external cardiac pacing and digoxin-specific FAB antibody fragments. Ann Emerg Med 19:38–43.

    Article  PubMed  CAS  Google Scholar 

  • Dart RC, Sidki A, Sullivan JB Jr, Egen NB, Garcia RA (1996) Ovine desipramine antibody fragments reverse desipramine cardiovascular toxicity in the rat. Ann Emerg Med 27:309–315.

    Article  PubMed  CAS  Google Scholar 

  • de Haro L, Lang J, Bedry R, Guelon D, Harry P, Marchal MF, Jouglard J (1996) Results of the tolerance study of a European F(ab)2 antivenom (Viperflow®) given as an i.v. infusion to patients poisoned by European vipers. Proceedings of the XVII International Congr. of the EAPCCT, Marseille, June 1996.

    Google Scholar 

  • Evans PJ, Evans RW, Bomford A, Williams R, Halliwell B (1994) Metal ions catalytic for free radical reactions in the plasma of patients with fulminant hepatic failure. Free Radic Res 20:139–144.

    Article  PubMed  CAS  Google Scholar 

  • Fang X, Fernando Q (1994) Synthesis, structure, and properties of rac-2,3-dimercaptosuccinic acid, a potentially useful chelating agent for toxic metals. Chem Res Toxicol 7:148–156.

    Article  PubMed  CAS  Google Scholar 

  • Flora GJ, Seth PK, Prakash AO, Mathur R (1995) Therapeutic efficacy of combined meso 2,3-dimercaptosuccinic acid and calcium disodium edetate treatment during acute lead intoxication in rats. Hum Exp Toxicol 14:410–413.

    Article  PubMed  CAS  Google Scholar 

  • Hoffman RS, Goldfrank LR (1995) The poisoned patient with altered consciousness. Controversies in the use of a ‘coma cocktail’ P.JAMA 274:562–569.

    CAS  Google Scholar 

  • Hojer J, Baehrendtz S, Matel G, Gustafsson LL (1990) Diagnostic utility of flumazenil in coma with suspected poisoning: a double blind, randomised controlled study. BMJ 301:1308–1311.

    Article  PubMed  CAS  Google Scholar 

  • Hoover TD, Aphosian HV (1983) BAL increases the arsenic-74 content of rabbit brain. Toxicol Appl Pharmacol 70:160–162.

    Article  PubMed  CAS  Google Scholar 

  • Jones A (1996) Should methionine be added to every paracetamol tablet? Proceedings of the XVII International Congr. of the EAPCCT, Marseille, June 1996.

    Google Scholar 

  • Kassa J (1995) Comparison of the effect of selected Cholinesterase reactivators combined with atropine on the toxicity of soman and fosdrin in mice. Sb. Ved. Pr. Lek. Fak. Karlovy Univ. Hradci Kralove 38:63–66.

    CAS  Google Scholar 

  • Kontoghiorghes GJ (1995) New concepts of iron and aluminium chelation therapy with oral L1 (deferiprone) and other chelators. A review. Analyst 120:845–851.

    CAS  Google Scholar 

  • Kruszewska S, Wiese M, Kolacinski Z, Mielczarska J (1996) The use of haemodialysis and 2,3 propanesulphonate (DMPS) to manage acute oral poisoning by lethal dose of arsenic trioxide. Int J Occup Med and Env Health 9:111–115.

    CAS  Google Scholar 

  • Lheureux P, Debailleul G, DeWitte O, Askenasi R (1990) Zolpidem intoxication mimicking narcotic overdose: response to flumazenil. Hum Exp Toxicol 9:105–107.

    Article  PubMed  CAS  Google Scholar 

  • Lheureux P, Even-Adin D, Askenasi R (1990) Current status of antidotal therapies in acute human intoxications. Acta Clin Belg Suppl 13:29–47.

    PubMed  CAS  Google Scholar 

  • Martens F, Koppel C, Ibe K, Wagemann A, Tenczer J (1990) Clinical experience with the bonzodiazepine antagonist flumazenil in suspected benzodiazepine or ethanol poisoning. J Toxicol Clin Toxicol 28:341–356.

    Article  PubMed  CAS  Google Scholar 

  • Nakayama GR, Roskos KV, Fritzinger BK, Heller J (1995) A study of reversibly inactivated lipases for use in morphine-triggered naltrexone delivery system. J Biomed Mater Res Nov 29 (11):1389–96.

    Google Scholar 

  • Pennisi E (1996) Chemicals behind the Gulf War Syndrome?. Science, 272:479–480.

    Article  PubMed  CAS  Google Scholar 

  • Plant JR, MacLeod DB (1994) Response of a promethazine-induced coma to flumazenil. Ann Emerg Med 24:979–982.

    Article  PubMed  CAS  Google Scholar 

  • Proudfoot AT (1995) Antidotes: benefits and risks. Toxicol. Letters 82/83:779–783.

    Google Scholar 

  • Reichl FX, Hunder G, Liebl B, Fichtl B, Forth W (1995) Effect of DMPS and various adsorbents on the arsenic excretion in guinea-pigs after injection with AS203 Arch Toxicol 69(10):712–7.

    Article  PubMed  CAS  Google Scholar 

  • Sabouraud A, Urtizberea M, Cano N, Gamier R, Scherrmann JM (1990) Specific anti-digoxin Fab fragments: an available antidote for proscillaridin and scilliroside poisoning? Hum Exp Toxicol 9:191–193.

    Article  PubMed  CAS  Google Scholar 

  • Scherrmann JM, Lang J, Pepin-Covatta S, Lutsch C (1996) Recent advances in the immunoreactivity of a new purified canine F(ab)2 preparation (Viperflow®) against European viper venom. Proceedings of the XVII International Congress of the EAPCCT, Marseille, June 1996.

    Google Scholar 

  • Shum S, Whitehead J, Vaughn L, Shum S, Hale T (1995) Chelation of organoarsenate with dimercaptosuccinic acid. Vet Hum Toxicol 37:239–242.

    PubMed  CAS  Google Scholar 

  • Smith TW, Haber E, Yeatman L, Butler VP (1976) Reversal of advanced digoxin intoxication with Fab fragments of digoxin specific antibodies. N Engl J Med 294:797–800.

    Article  PubMed  CAS  Google Scholar 

  • Tandon SK, Singh S, Jain VK (1994) Efficacy of combined chelation in lead intoxication. Chem Res Toxicol 7.

    Google Scholar 

  • Ubios AM, Braun EM, Cabrini RL (1994) Lethality due to uranium poisoning is prevented by ethane-1-hydroxy-1,1-biphosphonate (EHBP). Health Phys 66:540–544.

    Article  PubMed  CAS  Google Scholar 

  • Vance MV, Curry SC et al. (1986) Digital hydrofluoric acid burns of the skin with intra-arterial calcium infusion. Ann Emerg Med 15:890–896.

    Article  PubMed  CAS  Google Scholar 

  • Velvart J (1983) Arterial perfusion for hydrofluoric burns. Hum. Toxicol. 2:233–238.

    Article  PubMed  CAS  Google Scholar 

  • Weinbroum A, Rudick V, Sorkine P, Nevo Y, Halpern P, Geller E, Niv D (1996) Use of flumazenil in the treatment of drug overdose: a double-blind and open clinical study in 110 patients. Grit Care Med 24:199–206.

    Article  CAS  Google Scholar 

  • Wolff J, Capraro HG, Brossi A, Cook H (1980) Colchicine binding to antibodies. J Biol Chem 255:7144–7148.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. International Programme on Chemical Safety (IPCS)(WHO/ILO/UNEP), World Health Organization, CH-1211, Genève, Switzerland

    J. Pronczuk de Garbino

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  1. J. Pronczuk de Garbino
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Editors and Affiliations

  1. Interkantonale Kontrollstelle für Heilmittel, Erlachstrasse 8, CH-3000 Bern 9, Switzerland

    Jürg P. Seiler

  2. Dept. of Neurochemistry Campus San Juan, University of Alicante, Aptdo. 374, E-03080, Alicante, Spain

    Eugenio Vilanova

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© 1997 Springer-Verlag Berlin Heidelberg

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de Garbino, J.P. (1997). Evolution of Antidotal Therapy in Recent Decades. In: Seiler, J.P., Vilanova, E. (eds) Applied Toxicology: Approaches Through Basic Science. Archives of Toxicology, vol 19. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60682-3_24

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  • DOI: https://doi.org/10.1007/978-3-642-60682-3_24

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64505-1

  • Online ISBN: 978-3-642-60682-3

  • eBook Packages: Springer Book Archive

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