Sarcopenia, defined as the loss of skeletal muscle mass and function, is a major clinical problem in many chronic illnesses, in cancer and in the elderly. Starting from these new data, in the present review, we examined the evidence on the therapeutic potential of carnosine as an endogenous antidote that is able to rescue the Nrf2 pathway and then counteract drug-induced cardiotoxicity and neurotoxicity.īackground. Interestingly, carnosine (β-alanyl-l-histidine), an endogenous dipeptide that is characterized by strong antioxidant, anti-inflammatory, and neuroprotective properties is able to rescue/activate the Nrf2 pathway, as demonstrated by different preclinical studies and preliminary clinical evidence. Therefore Nrf2 represents a novel pharmacological target to develop new antidotes in the field of clinical toxicology. Cardiotoxic drugs, such as the anthracycline doxorubicin, or neurotoxic drugs, such as paclitaxel, suppress or impair the Nrf2 pathway, whereas the rescue of this pathway counteracts both the oxidative stress and inflammation that are related to drug-induced cardiotoxicity and neurotoxicity. The Nrf2 pathway regulates the expression of different genes whose products are involved in antioxidant and inflammatory responses and the detoxification of toxic species. Recent studies have demonstrated that the impairment of the nuclear factor erythroid 2–related factor 2 (Nrf2) pathway is a primary event in the pathophysiology of drug-induced cardiotoxicity and neurotoxicity. Indian J Crit Care Med 2019 23(Suppl 4):S241-S249.ĭifferent drug classes such as antineoplastic drugs (anthracyclines, cyclophosphamide, 5-fluorouracil, taxanes, tyrosine kinase inhibitors), antiretroviral drugs, antipsychotic, and immunosuppressant drugs are known to induce cardiotoxic and neurotoxic effects. This review provides an overview of the role of antidotes in poisoning.Ĭhacko B, Peter JV. Vitamins such as vitamin K, folic acid and pyridoxine are used to antagonise the effects of warfarin, methotrexate and INH respectively in the setting of toxicity or overdose. Drugs such as atropine and magnesium are used to counteract the end-organ effects in organophosphorus poisoning. Drugs such as N-acetyl cysteine and sodium thiocyanate reduce the formation of toxic metabolites in paracetamol and cyanide poisoning respectively. naloxone, flumazenil) are other mechanisms by which antidotes act. oximes for organophosphorus poisoning) and competitive receptor blockade (e.g. ethanol for methanol poisoning), enhancement of enzyme function (e.g. In some situations, enhanced elimination can be achieved by urinary alkalization or hemadsorption. Specific binders include chelating agents, bioscavenger therapy and immunotherapy. The most commonly used non-specific binding agent is activated charcoal.
#MAGNESIUM TOXICITY ANTIDOTE FREE#
Reduction in free toxin level can be achieved by specific and non-specific agents that bind to the toxin. Antidote administration may not only result in the reduction of free or active toxin level, but also in the mitigation of end-organ effects of the toxin by mechanisms that include competitive inhibition, receptor blockade or direct antagonism of the toxin. Antidotes mediate its effect either by preventing the absorption of the toxin, by binding and neutralizing the poison, antagonizing its end-organ effect, or by inhibition of conversion of the toxin to more toxic metabolites. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body.Antidotes are agents that negate the effect of a poison or toxin.
It works by relaxing the blood vessels so that blood can flow more easily through the body.
It is an opioid antagonist and it binds to opioid receptors and can reverse and block the effects of other opioids, such as heroin, and morphine. Naloxone -> is a drug that rapidly reverses opioid overdose.Vitamin K -> IV dose has also been shown to be a safe and effective method of warfarin reversal and it is used as an antidote. Individuals anticoagulated with warfarin or heparin are mainly treated with specific antidotes such as vitamin K or protamine.Magnesium toxicity is diagnosed when the concentration of magnesium in the blood reaches 1.74 to 2.61 millimoles per liter.The used dose for calcium chloride for magnesium toxicity is 500 mg of 10% calcium chloride IV given over 5-10 minutes. Calcium chloride can also be used in lieu of calcium gluconate.Repeat doses may be necessary in some cases. Dose is Calcium gluconate 1 g IV over 3 minutes.Calcium gluconate is used as an antidote for magnesium toxicity.
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