Toxicology: pearls and pitfalls in the use of antidotes

Although most poisonings require only supportive care, the emergency physician must recognize when the use of an antidote is required, and understand the risks and benefits of the treatment rendered. Although the more commonly instituted specific therapy in acute poisoning is the administration of intravenous fluids followed by the administration of oxygen, in certain circumstances prompt administration of a specific antidote may be required, and failure to identify these circumstances may lead to significant morbidity or mortality. This article describes select antidotes, and discusses their indications and potential pitfalls.