Sunderland Joint Formulary Formulary


	Sunderland Joint Formulary NHS Sunderland Clinical Commissioning Group South Tyneside and Sunderland NHS Foundation Trust

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Formulary Chapter 23: Antidotes - Full Chapter

Notes:

This chapter provides a list of antidotes held by City Hospitals Sunderland. These medications are red in the context of emergency antidotes held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Details...

23.01

Antidotes held at City Hospitals Sunderland

Acetylcysteine

Formulary

Injection: 2 g/10 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Alcohol (ethanol)

Formulary

Injection: 2 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Atropine sulphate

Formulary

Injection: 600 micrograms/1 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Calcium chloride

Formulary

Injection: 10 mmol/10 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Calcium gluconate

Formulary

Injection: 10 % (1 g/10 mL) ampoules
Gel: 25 g tube

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Charcoal (activated)

Formulary

Oral suspension: 50 gm/250 mL

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Cyproheptadine hydrochloride

Formulary

Tablets: 4 mg

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Dantrolene sodium

Formulary

Injection: 20 mg vials

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Desferrioxamine mesilate

Formulary

Injection: 500 mg, 2 g vials

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Diazepam (emulsion)

Formulary

Injection: 10 mg/2 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Dicobalt edetate

Formulary

Injection: 300 mg/20 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Digoxin specific antibody fragments (Digifab®)

Formulary

Injection: 40 mg vial

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Flumazenil

Formulary

Injection: 500 micrograms/5 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Folinic acid (calcium folinate)

Formulary

Injection: 30 mg/10 mL, 300 mg/30 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Fomepizole (4-methylpyrazole)

Formulary

Injection: 100 mg/20 mL, 1.5 g/1.5 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Glucagon

Formulary

Injection: 1 mg syringe

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Glyceryl trinitrate

Formulary

Injection: 10 mg/10 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Hydroxocobalamin

Formulary

Injection: 5000 mg vial (Cyanokit®)

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Intralipid®

Formulary

Injection: 20% infusion 500 mL

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Isosorbide dinitrate

Formulary

Injection: 0.05% (25 mg/50 mL) vial
Injection: 0.1% (10 mg/10 mL) vial

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Lorazepam

Formulary

Injection: 4 mg/1 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Macrogol ‘3350’

Formulary

Sachet: Klean-Prep®

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

MESNA (sodium 2-mercapto-ethanesulphonate)

Formulary

Injection: 400 mg/4 mL ampoules
Tablets: 400 mg

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Methylthioninium chloride (methylene blue)

Formulary

Injection: 1 % (100 mg/10 mL) ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Naloxone

Formulary

Injection: 400 micrograms/1 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Octreotide

Formulary

Injection: 50 micrograms/1 mL, 100 micrograms/1 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Phentolamine

Formulary

Injection: 10 mg/1 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Phytomenadione (vitamin K)

Formulary

Injection: 10 mg/1 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Procyclidine

Formulary

Injection: 10 mg/2 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Protamine sulphate

Formulary

Injection: 50 mg/5 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Pyridoxine (high dose)

Formulary

Injection: 100 mg/2 mL ampoules
Injection: 300 mg/2 mL ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Sodium bicarbonate

Formulary

Injection: 1.26 % Polyfusor® infusion 500 mL
Injection: 8.4 % (840 mg/10 mL) ampoules, Polyfusor® infusion 200 mL

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Sodium nitrite

Formulary

Injection: 3% (300 mg/10 mL) ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Sodium thiosulphate

Formulary

Injection: 50% (10 g/20 mL) ampoules

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

Viper venom antiserum

Formulary

Injection: 1g vials

Red as an emergency antidote held by City Hospital Sunderland. Please see other chapters for formulary status when used for other indications.

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Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.
	These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.
	Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case.
	These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.