分類           放置位置 物質解毒劑         連結 ref
藥品代號 藥品學名 藥品商品名(中文名) 單位 外觀圖示 門診 急診 適應症 使用劑量 注意事項 使用流程 通報流程    

11A065 抗出血性蛇毒血清 (抗龜殼花) Antivenin Hemorrhagic(抗出血性蛇毒血清) V   急診冰箱 對抗青竹絲、龜殼花咬傷

百步蛇 抗百步蛇蛇毒血清 單價 2~4vial

龜殼花 抗龜殼花及赤尾鮐混合蛇 多價 1~2vial

赤尾鮐 抗龜殼花及赤尾鮐混合蛇 多價 1~2vial

小心血清性休克 一般 P11-12 全國解毒劑儲備網
11A073 抗神經性蛇毒血清 (抗雨傘節) Antivenin Neurotropic(抗神經性蛇毒血清) V     急診冰箱 對抗眼鏡蛇、雨傘節咬傷  

雨傘節 抗雨傘節及眼鏡蛇混合蛇毒血清 多價 1~4vial

眼鏡蛇 抗雨傘節及眼鏡蛇混合蛇毒血清 多價

(西部6 vial)

(東部12vial)

 

小心血清性休克 一般 P11-12 全國解毒劑儲備網

 13C057 Sod.thiosulfate/Sod.nitrite Cyanide Antidote(氰化物解毒劑) Package     急診急救櫃最下層 氰化物中毒  

a).amyl nitrite 0.3ml/Amp (紗布包裝)直接捏碎吸入,每分鐘 吸30秒,每瓶使用3至4分鐘

b).3% Sodium nitrrite(300mg/10ml/Amp) 10ml, IV 注射5分鐘;兒童0.33ml/kg , 最多 10ml

c). 25% sodium thiosulfate (12.5gm/50ml/Amp) 12.5gm/50ml , IV 注射 10min 兒童 1.65 ml/kg

(ref 行政院衛生署 毒藥物防治諮詢中心)

  依解毒劑使用流程 依解毒劑通報流程 wd01-02, p24  

27C119 Charcoal Activated 50gm Carbomix (61.5gm) Bt.(蓋抹滅顆粒劑) BT   UD 急診冰箱旁 藥物中毒(金屬、有機溶劑、氰化物中毒等除外)  

Adult
Antidote (adsorbent): PO, as a slurry in water
Single-dose therapy: 25-100 g.
Multiple-dose therapy: Initial 50-100 g, followed by 12.5 g q1h, 25 g q2h, or 50 g q4h.
Pediatric
Antidote (adsorbent): PO, as a slurry in water
Single-dose therapy:≦ 1 yr, 10-25 g or 0.5-1 g/kg; 1-12 yrs: 25-50 g or 0.5-1 g/kg.
Multiple-dose therapy: ≦13 yrs, Initial 10-25 g, followed by 1-2 g/kg q 2-4h.

(ref 院內處方集)

  一般 P3  
17V121 Vit. K1 10mg 1ml/A Vit. K1 (10mg 1ml/A) inj.(維生素 k活性) A   UD 針劑儲放櫃 抗凝血劑中毒

Serious bleeding at any elevation of INR
Hold warfarin therapy and give vitamin K (10 mg by slow IV infusion), supplemented with FFP, PCC, or
rVIIa, depending on the urgency of the situation; vitamin K can be repeated q12h

(ref Pharmacology and Management of the Vitamin K Antagonists.2008)

需slow IV push (<1mg/min) 一般 P21-22  
12N022 Naloxone 0.4mg/ml 1ml NARCAN  0.4MG/ML A   UD 針劑儲放櫃 opioid overdose

成人用法:

起始量為0.4mg至2mg,由靜脈注射,若未達到預期的復甦效果或改善呼吸功能,於投藥後隔2至3分鐘再重復給藥,若投予10mg仍未有反應,宜考慮是否為鴉片類藥品引起之中毒,若無法肌肉注射時,則可改以肌肉注射或皮下注射

兒同用法:

起始為0.01mg/kg 靜脈注射, 若未達到預期的復甦效果追加投予0.1mg/kg 若無法肌肉注射時,則可改以肌肉注射或皮下注射

(ref 仿單)

可能產生及加重戒斷症狀 一般  

Medicine 2007 35: 10

dose ref. 仿單

13F058 Flumazenil 0.5mg/5ml ANEXATE(FLUMAZENIL) 0.5MG/5ML V   UD 針劑儲放櫃 bezodiazepine中毒 0.5 mg intravenously over 1 minute, the same dose repeated if there is no response or only a partial response 禁用產生抽搐患者 一般   Resuscitation (2007) 74, 27—37
14P022 Protamine 10mg/ml 5ml

Protamine (10mg/ml) 5ml inj.

(理奧硫酸魚精蛋白)

A   門診冰箱 急診冰箱 heparin及低分子量heparin 過量

Heparin overdosage: IV, 1 mg for every 100 units of heparin remaining in patient (if 30 mins have elapsed since the injection of heparin, 1/2 dose may be sufficient); slow IV, loading dose of 25 - 50 mg, with the rest of the calculated dose over 8-16 hrs; or 25-50 mg should be given immediately after the discontinuation of a continuous infusion of heparin

(ref 院內處方集)  

  一般    
25F011 Acetylcysteine 200mg/3gm Fluimucil(200mg/3gm) (Actein)(愛克痰) PK   門診及UD 口服儲放櫃 acetaminophen overdose 140mg/kg for first dase, then70mg/kg, q4h使用17doses   一般 P25 N Engl J Med 2008;359:285-92
15A033 Acetylcysteine 300mg/3ml/A

ENCORE(FLUIMUCIL) INJ .   300mg/3ML/A

(安喀寶)

A   UD 針劑儲放櫃 acetaminophen overdose

八小內使用

140mg/kg for first dase, then70mg/kg, q4h使用17doses

  一般 P25 N Engl J Med 2008;359:285-92
16S011 Sod. Bicarbonate 70mg/ml 20ml

ROLIKAN(SOD. BICARBONATE)  20ml

(樂麗康)

A   UD 針劑儲放櫃 巴比妥酸、水楊酸、三環抗憂鬱劑中毒  用來治療酸中毒症狀, 依其症狀給予   一般    
13L026 Lorazepam 2mg/ml

ANXICAM INJ. 2MG(ATIVAN)

(安心平注射液2公絲/公撮(樂必寧))

V     急診冰箱 酒精戒斷  

Alcohol withdrawal syndrome: 2 mg ORALLY every 6 hr for 4 doses, then 1 mg every 6 hr for 8 doses

(ref micromedex )

  一般    
17V155 CaCl2.H2O/Glucose.H2O,20/100mg

Calcium Chloride+Glucose 20ml(美達加祿注射液)

A   UD 針劑儲放櫃 高血鉀、鈣離子阻斷劑過量、氫氟酸中毒 adult & child 應監測EKG及血鈣變化 一般   全國解毒劑儲備網

23P134 D-penicillamine F.C.T 300mg Metalcaptase(300mg) F.C.Tab. Tab   門診後中央   砷、銅、汞、鉛等中毒 15~40mg/kg/d (max 2g/day) 青黴素過敏者禁用,應監測肝、腎功能 一般 P15  
17D072 Desferrioxamine 500mg Desferal (500mg) inj. A  
UD   鐵及鋁中毒 Severe (IV infusion)–Begin at 15 ~35 mg/kg/hour during first 24 hours for severe ingestions
IM:40mg/kg/dose (每次不超過2g,每天不超過6g)
Dosage for aluminum intoxication
5mg/kg (IV infusion 60 min)
應監測血壓變化 一般 P17  
17D109 DMPS 250mg/5ml Dimaval (250mg/5ml)(螯金拔注射劑) A   急診解毒櫃
急性汞中毒解毒劑
250 mg Q6H IV for 7 days, then every 250 mg Q8H IV for 1 day, then 250 mg Q12H IV for 8 days, then 250 mg QD IV for 7 days.
過敏性氣喘患者使用本藥時須特別小心、腎功能不全患者使用本藥需同時進行血液透析
依解毒劑使用流程
依解毒劑使用流程
 
MICROMEDEX
17E037 Edetate Ca 1000mg/5mL/A EDTA(1000mg/5mL/A)(佑得立注射劑) A   急診解毒櫃
鉛中毒解毒劑
成人:1g以250~500ml之5%葡萄糖注射液或0.9%生理食鹽水予以稀釋,IV滴需一個小時,一日兩回,療程五天。之後如需要,停止兩天後再做五天點滴。
兒童:每15kg注射0.5g以下,一日兩回
 
依解毒劑使用流程
依解毒劑使用流程
  仿單
27D116 Dimercaptosuccinate 200mg Dimersu(200mg)膠囊/重金屬解毒(帶金速膠囊) Tab   急診解毒櫃
鉛、砷、汞中毒之解毒劑
Lead poisoning:10 mg/kg/dose (or 350 mg/m2/dose) Q8H for 5 days, followed by 10 mg/kg/dose (or 350 mg/m2/dose) Q12H for 14 days. Max. 500 mg/dose.
若小孩無法吞服膠囊,打開膠囊和少量軟質食物放在湯匙再搭配果之服用
依解毒劑使用流程 依解毒劑使用流程  
MICROMEDEX

13A045 Atropin 1mg/ml 1ml Atropin (1mg/ml) inj. 1ml(硫酸阿扥品) A   UD 針劑儲放櫃 有機磷中毒、anticholinesterase 2-5mg IV bolus (0.05mg/kg IV in children) and escalate (double) dose every 3-5 min, until à bronchial secretions & wheezing stop  注意乙醯膽鹼藥物過量症狀 一般 解毒劑流程  
17P018 Pralidoxime Cl 500mg /20ml

P.A.M. 500mg  20ml

(杷母巴拉)

A   UD 針劑儲放櫃 有機磷中毒(non-carbamate) 2g (25-30 mg/kg in children) IV over 30 min; Continuous infusion at 8 mg/kg/hr in adults (10-20mg/kg/hr in children)    一般    

27D108 Deferasirox 125mg dispersible Exjade (125mg) Table(易解鐵可溶錠125毫克 ) Tab   UD 口服儲放櫃 慢性輸血性鐵中毒  
Transfusion hemosiderosis
a) INITIAL
1) Initiate deferasirox when there is evidence of chronic iron overload, such as transfusion of approximately 100 milliliters/kilogram (kg) of packed red blood cells (equivalent to approximately 20 units for a 40 kg patient) and a serum ferritin consistently over 1000 micrograms/liter (Prod Info EXJADE(R) oral suspension, 2007).
2) The recommended initial dose of deferasirox is 20 milligrams/kilogram orally once daily with monthly monitoring of serum ferritin (Prod Info EXJADE(R) oral suspension, 2007).
b) MAINTENANCE
1)The dose of deferasirox may be adjusted, if necessary, every 3 to 6 months based on serum ferritin trends. Increments of 5 or 10 milligrams/kilogram for dosage adjustments are recommended and should be tailored to the individual patient's response and goals. If the serum ferritin level consistently falls to below 500 micrograms/liter, temporary interruption of deferasirox should be considered (Prod Info EXJADE(R) oral suspension, 2007).
c) MAXIMUM DOSE
1)The maximum dose of deferasirox is 30 milligrams/kilogram/day, as limited information exists above this dose (Prod Info EXJADE(R) oral suspension, 2007).

Dosage in Renal Failure
A) For increases of serum creatinine of more than 33% on 2 consecutive visits, reduce the daily dose of deferasirox by 10 milligrams/kilogram (Prod Info EXJADE(R) oral suspension, 2007).B) Deferasirox should be temporarily or permanently discontinued, if there is a progressive rise in serum creatinine. Re-initiate at a lower dose once the creatinine returns to within the normal limit. The dose may be gradually increased if the clinical benefit outweigh the potential risks (Prod Info EXJADE(R) oral suspension, 2007)
C) Deferasirox has not been studied in patients with baseline renal impairment (Prod Info EXJADE(R) oral suspension, 2007).
Dosage in Hepatic Insufficiency

A)Dose modifications should be considered for severe or persistent elevations in transaminase levels (Prod Info EXJADE(R) oral suspension, 2007).
B)The pharmacokinetics of deferasirox were not altered in patients with baseline transaminase levels up to 5 times the upper limit of normal (Prod Info EXJADE(R) oral suspension, 2007).

(ref 院內處方集)

  一般    
13M049 Methylene Blue Methylene Blue (100mg/10ml) (甲烯藍 注射液) A     急診急救櫃最下層 變性血紅素血症  

1% Methylene Blue 及 100% 氧氣 1-2ml/kg/dose 1% 水劑, IV注射 5min,必要時每四小時注射一次

(ref 行政院衛生署 毒藥物防治諮詢中心)

禁用G-6PD缺乏患者 一般    
11T026 T.Toxoid 0.5ml/DS 20ml

Tetanus Toxoid (0.5ml/DS) 20ml

(明礬沉澱破傷風類毒素)

V     急診冰箱 利器切、割傷

Tetanus, immunization: 0.5 ml/dose, given at 0 and 4-8 wks, and at 6-12 mo after 2nd dose; booster dose every 5-10 yrs.

(ref 院內處方集)

  一般    
13A011 Biperiden Lactate 5mg/ml inj BIPIDEN 5MG/ML(AKINETON)(美必定) A   UD 針劑儲放櫃 急性EPS發作  

兒童 : 0.02 mg/kg , 最多 0.5 mg IV 5-10min , 如無效可重覆給藥至2mg為止

成人 : 1 mg IV 5-10min 若未恢復可重覆給藥一次

(ref 行政院衛生署 毒藥物防治諮詢中心)

  一般