DorsetThe Dorset Formulary has been developed in associations with NHS Dorset Clinical Commissioning Group Dorset County Hospital NHS Foundation Trust Dorset Healthcare University NHS Foundation Trust University Hospitals Dorset NHS Foundation Trust
Please see individual entries for local availability of
antidotes.
In cases of poisoning
it is strongly recommended that advice is sought from NPIS by telephone on 0344
892 0111 or online using Toxbase. Advice
is available 24/7/365.
See the current
BNF for notes on the emergency treatment of poisoning or click on the BNF
icon adjacent to individual drugs for further details.
Details...
18
Poisoning
Acetylcysteine IV (Parvolex)
Formulary
See BNF for treatment graph and acetylcysteine treatment protocols for paracetamol overdose.
Activated charcoal
Formulary
For reduction of absorption of poisons in the gastro-intestinal system. Useful for many oral poisons (but see Toxbase or NPIS for advice on use).
Atropine injection
Formulary
For bradycardia and organophosphate or carbamate insecticide poisoning.
Calcium chloride injection
Formulary
For calcium channel blocker overdose and systemic effects of hydrofluoric acid.
Calcium folinate
Formulary
For methotrexate overdose or poisoning and methanol or formic acid poisoning.
Calcium gluconate
Formulary
Injection (by local infiltration) and gel (topically) for hydrofluoric acid burns.
RBCH: Gel kept in ED Resus
Cyproheptadine (Periactin®)
Formulary
Anticholinergic (antimuscarinic) antihistamine used in serotonin syndrome.
RBCH: kept in EDC and pharmacy
Dantrolene IV
Formulary
For malignant hyperthermia, neuroleptic malignant syndrome (NMS). Other drug related pyrexia seek NPIS advice.
Orally or by injection for ethylene glycol (antifreeze) and methanol (methyl alcohol) poisoning as alternative to fomepizole.
European Viper Venom Antivenom
Formulary
For European adder (Vipera berus) envenoming (bites).
DCH: Kept in ED Fridge & Emergency Drugs Fridge.
Flumazenil
Formulary
For reversal of benzodiazepines.
Fomepizole
Formulary
Unlicensed. Treatment of choice for methanol (methyl alcohol) and polyethylene glycol (antifreeze) poisoning. PbR excluded: Commissioned by CCG.
There is an agreement that DCH, RBCH and PHT will keep initial doses of fomepizole to allow time for additional doses to be sourced from other trusts - contact Pharmacy to arrange supplies
DCH: Available in Emergency Drugs Fridge.
RBCH: Kept on ITU
Glucagon injection (GlucaGen® Hypokit)
Formulary
For treatment of hypoglycaemia due to insulin overdose and supportive off-label (unlicensed) treatment of beta-blocker overdose. Other indications e.g. calcium channel blockers, seek NPIS advice.
Beta-blocker overdose requires large amounts of glucagon - contact Pharmacy to arrange supplies ASAP.
Glucarpidase
Formulary
Orphan drug
High Cost Medicine: Commissioned by NHS England for urgent treatment of methotrexate-induced renal dysfunction in accordance with policy.
Due to the cost of this antidote for methotrexate toxicity, it is not stocked at any hospital in the area. If a supply is needed it can be obtained on a named-patient basis from Clinigen Group 24 hours a day 7 days a week. Within office hours: Tel: 01283 494 340 Fax: 01283 494 341 Out of hours: Email: outofhours@clinigengroup.com Phone number: 07741 242858
Hydroxocobalamin (Cyanokit®)
Formulary
Can be considered for use in victims of smoke inhalation who show signs of significant cyanide poisoning.
RBCH: 1 kept in ED; obtain further supplies from PHT
Macrogols (Klean-Prep® or similar)
Formulary
For gut decontamination of agents not bound by activated charcoal (e.g. iron & lithium).
Unlicensed. For treatment of methaemoglobinaemia and as a diagnostic aid for fistula detection.
RBCH: kept in ITU and Theatres
Naloxone injection
Formulary
For emergency treatment of opioid overdose.
Octreotide injection
Formulary
For sulphonylurea overdose.
Penicillamine (Distamine®)
Formulary
Phentolamine injection
Formulary
For digital ischemia due to accidental injection of epinephrine (adrenaline) and resistant hypertension related to sympathomimetic drugs of abuse, MAOIs and clonidine.
Phytomenadione (Vitamin K1)
Formulary
For reversal of warfarin and other coumarin anticoagulants (vitamin K1 antagonists).
Pralidoxime chloride (Protopam®)
Formulary
For use as an adjunct to atropine in the treatment of poisoning by organophosphorus insecticides or nerve agents. ‘NAAS pods’ containing pralidoxime chloride can be obtained through the Ambulance Service from the National Blood Service — see NPIS or TOXBASE for list of designated centres.
RBCH is a designated regional holding site - kept in ED Resus
Procyclidine injection
Formulary
For dystonic reactions.
RBCH: kept in Emergency Drug Cupboard, ED resus and AMU
Protamine Sulphate
Formulary
For emergency reversal of heparin based anticoagulants.
Pyridoxine injection
Formulary
For isoniazid toxicity.
Sodium bicarbonate infusion
Formulary
Use for urinary alkalinisation & tricyclic antidepressant overdose & class 1a and 1c antiarrhythmic drugs.
Sodium nitrite injection
Formulary
For cyanide poisoning.
RBCH: kept in Emergency Drug Cupboard
Sodium thiosulphate
Formulary
For cyanide poisoning.
RBCH: kept in Emergency Drug Cupboard
Tetanus Immunoglobulin (antidote botulism)
Formulary
For treatment of tetanus infection (botulism)
18.11.01
Skin cleansers and antiseptics
18.11.07
Preparations for promotion of wound healing
....
Non Formulary Items
Dimercaprol
Non Formulary
Check Rarely Used Medicines (RUM) list for stockists if required.
DMPS (unithiol)
Non Formulary
Available from Poisons Unit at Guys & ST Thomas' Hospital if supply required.
Sodium calcium edetate
Non Formulary
Southampton is nearest centre to stock this item.
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 children's BNF
Link to SPCs
Cytotoxic Drug
Controlled Drug
High Cost Medicine
Cancer Drugs Fund
NHS England
Homecare
CCG
Traffic Light Status Information
Status
Description
May be initiated, stabilised and maintained in primary, secondary or tertiary care
Amber drug - without shared care
Amber drug - with shared care guideline
For secondary or tertiary care initiation and long-term maintenance of prescribing