Antidote Stocking at Hospitals in North Palestine

Objective: The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking. Methodology: This study is a cross sectional survey of all hospitals at north Palestine (n=11) using a questionnaire which was completed by the director of the pharmacy department at each hospital. The questionnaire was divided into 2 parts. The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes. This classification is based on the guideline proposed by the British Association for Emergency Medicine (BAEM). The net antidote stock results were compared with the American guidelines as well. Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100% for atropine. The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes. Additionally, availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100% for dobutamine. The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes. Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also important

How we treat bleeding associated with direct oral anticoagulants

Direct oral anticoagulants are at least as effective as vitamin K antagonists for the prevention and treatment of thromboembolism. Unfortunately, differently from vitamin K antagonists, they have the great drawback of lacking specific antidotes in the case of bleeding or emergency situations such as trauma, stroke requiring thrombolysis, and urgent surgery. The progressive development of antidotes for these new drugs, which, it is hoped, will become available in the near future, will allow better and safer management of the rapid reversal of their anticoagulant effect

Diversity of Poisonous Plants and their Antidotes, Affecting Ruminant Livestock Production on Rangelands in Ghana

The survival of the extensive livestock system, the practice for most farmers in the livestock industry in Ghana depends heavily on the natural pastures as forage resource. To efficiently use the rangelands, knowledge of the species composition, especially that of poisonous plants is essential. Documented knowledge in Ghana is scanty; documentation and dissemination of the knowledge resource would enable a wider access and wider benefit to stakeholders. A study was conducted in Ghana on poisonous plants with the aim to discover the existence and diversity of poisonous plants and associated antidotes affecting livestock for documentation and preservation of knowledge. 70 different items were cited; 22 were poisonous plants for which antidotes were not cited, 28 were poisonous plants with known antidotes and 32 antidotes. There were 575 citations of plants from 194 reported cases of suspected plant poisoning, categorized as poisonous plants for which no antidotes were cited (146), poisonous plants with cited antidotes (147) and antidotes (282). 50 plants species were identified and belonged to 29 plant families. Some plants were known only by local names. There was an extensive knowledge of the diversity of poisonous plants and antidotes within the ecological zones along with possible antidotes

Antidote application: an educational system for treatment of common toxin overdose

Poisonings account for almost 1% of emergency room visits each year. Time is a critical factor in dealing with a toxicologic emergency. Delay in dispensing the first antidote dose can lead to life-threatening sequelae. Current toxicological resources that support treatment decisions are broad in scope, time-consuming to read, or at times unavailable. Our review of current toxicological resources revealed a gap in their ability to provide expedient calculations and recommendations about appropriate course of treatment. To bridge the gap, we developed the Antidote Application (AA), a computational system that automatically provides patient-specific antidote treatment recommendations and individualized dose calculations. We implemented 27 algorithms that describe FDA (the US Food and Drug Administration) approved use and evidence-based practices found in primary literature for the treatment of common toxin exposure. The AA covers 29 antidotes recommended by Poison Control and toxicology experts, 19 poison classes and 31 poisons, which represent over 200 toxic entities. To the best of our knowledge, the AA is the first educational decision support system in toxicology that provides patient-specific treatment recommendations and drug dose calculations. The AA is publicly available at http://projects.met- hilab.org/antidote/

Optimal Resource Allocation for Network Protection Against Spreading Processes

We study the problem of containing spreading processes in arbitrary directed networks by distributing protection resources throughout the nodes of the network. We consider two types of protection resources are available: (i) Preventive resources able to defend nodes against the spreading (such as vaccines in a viral infection process), and (ii) corrective resources able to neutralize the spreading after it has reached a node (such as antidotes). We assume that both preventive and corrective resources have an associated cost and study the problem of finding the cost-optimal distribution of resources throughout the nodes of the network. We analyze these questions in the context of viral spreading processes in directed networks. We study the following two problems: (i) Given a fixed budget, find the optimal allocation of preventive and corrective resources in the network to achieve the highest level of containment, and (ii) when a budget is not specified, find the minimum budget required to control the spreading process. We show that both resource allocation problems can be solved in polynomial time using Geometric Programming (GP) for arbitrary directed graphs of nonidentical nodes and a wide class of cost functions. Furthermore, our approach allows to optimize simultaneously over both preventive and corrective resources, even in the case of cost functions being node-dependent. We illustrate our approach by designing optimal protection strategies to contain an epidemic outbreak that propagates through an air transportation network

Mechanism of Cyanide Toxicity and Efficacy of its Antidotes

This paper attempts to review the various antidotes available for countering cyanide threat in the light of the toxicity associated with it. It also critically evaluates the drawbacks and advantages of these antidotes for their therapeutic and/or prophylactic utility. The physico-chemical properties of hydrogen cyanide which make it a chemical warfare agent have also been highlighted. In an attempt to make the complex chemical and biological processes understandable, the chemical structures of the antidotes have been included and simple mechanistic pathways have been used to show the role of antidotes in activating the inhibited enzymes