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Updated: Aug 6, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
New and novel antidotes in pediatrics
Diane P Calello1, Kevin C Osterhoudt, Fred M Henretig
1Division of Emergency Medicine and the Poison Control Center, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. calello@email.chop.edu
Abstract:
Antidotal therapy can be lifesaving in the management of poisoned children. Although supportive care is sufficient in many cases, a specific antidote can significantly reduce morbidity and mortality in a number of poisoning scenarios, and so the pediatric emergency medicine practitioner must be familiar with its indications for use, dosage and administration, and contraindications. A number of new antidotes have emerged in recent years. This review discusses the pediatric uses and limitations of intravenous N-acetylcysteine, octreotide, crotaline Fab antivenom, fomepizole, atropine and pralidoxime autoinjectors and provides some brief discussion on newer antidotes for which data is only starting to emerge.
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Antidotes
Specific antidotes operate by inhibiting the enzymes that control biochemical pathways, reducing the production of harmful metabolites.
An example of an antidote is atropine, which counteracts the detrimental effects of cholinesterase inhibitors. It achieves this by deactivating muscarinic receptors,...
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