An essential co-factor in the synthesis of clotting factors II, VII, IX and X. It is used for the reversal of coumadin-induced coagulopathy. Warfarin overdose, no therapeutic need for warfarin (i.e. took someone else’s): Give 5 mg of vitamin K PO or IV daily for 2 days and recheck INR in 48 hours. Warfarin overdose, […]
LITFL Blog Archive
Sugammadex is used for reversal of the amino steroid neuromuscular blocking drugs rocuronium, vecuronium and pancuronium. It does not work on non-amino steroid neuromuscular blocking drugs (atracurium, cisatracurium and suxamethonium). Sugammadex can be titrated in theatre with the use of TOF but this post will focus on the emergency reversal in the emergency department. Administration Immediate reversal […]
Succimer (DMSA) is an orally active metal chelator is used to treat heavy metal poisoning. In adults Succimer is used for symptomatic lead poisoning or in patients who are asymptomatic with levels >60 micrograms/dL (>2.9 micro mol/L). In paediatrics it is used for symptomatic lead poisoning or in patients who are asymptomatic with levels >45 […]
Sodium Thiosulfate for cyanide toxicity.
Sodium Calcium Edetate (EDTA) is an intravenous heavy metal chelating agent. EDTA is primarily used in the treatment of severe lead poisoning with or without lead encephalopathy or an asymptomatic/mildly symptomatic patient with a serum lead level >70 microgram/dL (3.38 micro mol/L). EDTA is second line to succimer as a chelator and should not be […]