EpistemisAnalytical summary: systemic toxicities and their specific antidotes
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The molecular relationship between xenobiotic aggression and the rescue mechanism of the corresponding antidote is summarized in an integrated manner below.
| Xenobiotic / Toxon | Affected Cellular Target | Antidote of Choice | Molecular Mechanism of the Antidote |
|---|---|---|---|
| Paracetamol (Overdose) | Hepatic glutathione and NAPQI adducts | N-Acetylcysteine (NAC) | Restores glutathione and acts as an alternative nucleophilic substrate. |
| Opioids (Fentanyl, Morphine) | Mu (µ) opioid receptors in the CNS | Naloxone | Pure, high-affinity competitive antagonist of mu receptors. |
| Benzodiazepines (Overdose) | Allosteric site of the GABAA receptor | Flumazenil | Competitive antagonist of the benzodiazepine binding site in GABAA. | Organophosphates / Insecticides | Acetylcholinesterase (AChE) | Atropine + Pralidoxime | Muscarinic antagonist (atropine) and AChE reactivator by dephosphorylation (oxime). |
| Methanol / Ethylene Glycol | Hepatic Alcohol Dehydrogenase (ADH) | Fomepizole | Ultra-potent competitive inhibitor of ADH, prevents toxic acid metabolites. |
| Ferric Iron (Fe3+) | Mitochondrial oxidative cellular metabolism | Deferoxamine | Selective chelating agent, hydrophilic form of ferrioxamine that can be eliminated through urine. |
| Dabigatran (Pradaxa) | Soluble and clot-bound thrombin | Idarucizumab (Praxbind) | Humanized Fab fragment that sequesters dabigatran with ultra-high affinity. |
| Rocuronium / Vecuronium | ACh receptors in muscle motor plate | Sugammadex (Bridion) | Modified synthetic cyclodextrin that irreversibly encapsulates the drug. |
Epistemis is educational review material. It is not a medical device, does not diagnose or prescribe treatment, and does not replace formal medical training, current clinical guidelines, or professional clinical judgment.
- System
- Immunology, Oncology and Toxicology