Poisoning & Overdose

Also: toxicology · self-poisoning · drug overdose

Poisoning and overdose require rapid assessment, supportive care, and — for specific toxins — antidotes and nomogram-guided treatment. Toxicology pathways cover the common and dangerous agents.

The relevant tools, antidotes and toxicology pathways are gathered here.

Calculators & scores

Rumack-Matthew Nomogram

Toxicology
Done Nomogram (Salicylate Toxicity)

Toxicology
Kings College Criteria for Paracetamol Toxicity

Hepatology
King's College Criteria for Acute Liver Failure

Prognosis

Decision pathways

Salicylate (aspirin) overdose

TOXBASE/NPIS; AACT/EAPCCT; EXTRIP
Methanol / ethylene glycol poisoning

TOXBASE/NPIS; AACT/EAPCCT; EXTRIP
Paracetamol overdose

TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
Anticholinergic toxidrome

TOXBASE/NPIS; AACT/EAPCCT
Calcium channel blocker overdose

TOXBASE/NPIS; AACT/EAPCCT; ESC
Iron overdose

TOXBASE/NPIS; AACT/EAPCCT
Mushroom poisoning

TOXBASE/NPIS; AACT/EAPCCT; EASL
Isoniazid (INH) overdose

TOXBASE/NPIS; AACT/EAPCCT

Drugs

Sodium Bicarbonate

Alkalising Agent / Electrolyte
Acetylcysteine (N-acetylcysteine — Paracetamol Overdose)

Mucolytic / Hepatoprotective Antidote
Flumazenil

Benzodiazepine Receptor Antagonist
Naloxone (Intravenous — Opioid Reversal)

Opioid Receptor Antagonist
Naloxone

Opioid Antagonist
Sodium Bicarbonate 8.4%

Electrolyte Buffer
Acetylcysteine (N-acetylcysteine — NAC)

Antidote — paracetamol overdose / Hepatoprotectant
Activated Charcoal

Gastrointestinal decontamination / Antidote
Fomepizole

Antidotes & Toxicology
Naloxone hydrochloride

Pure μ-opioid receptor antagonist
Oxycodone with naloxone

Strong opioid + peripheral opioid antagonist
Sodium bicarbonate with sodium chloride

Alkalinising IV solution

Decision support only. These tools are aggregated by topic to aid navigation — always apply clinical judgement and the relevant national or local guideline.