Antidotes for childhood toxidromes

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Kam Lun Hon, Wun Fung Hui, Alexander KC Leung

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Background: Poisoning causes significant morbidity and sometimes mortality in children worldwide. The clinical skill of toxidrome recognition followed by the timely administration of an antidote specific for the poison is essential for the management of children with suspected poisoning. This is a narrative review on antidotes for toxidromes in paediatric practice.

Methods: A literature search was conducted on PubMed with the keywords “antidote”, “poisoning”, “intoxication”, “children” and “pediatric”. The search was customized by applying the appropriate filters (species: humans; age: birth to 18 years) to obtain the most relevant articles for this review article.

Results: Toxidrome recognition may offer a rapid guide to possible toxicology diagnosis such that the specific antidote can be administered in a timely manner. This article summarizes toxidromes and their respective antidotes in paediatric poisoning, with an emphasis on the symptomatology and source of exposure. The antidote and specific management for each toxidrome are discussed. Antidotes are only available for a limited number of poisons responsible for intoxication. Antidotes for common poisonings include N-acetyl cysteine for paracetamol and sodium thiosulphate for poisoning by cyanide.

Conclusion: Poisoning is a common cause of paediatric injury. Physicians should be familiar with the recognition of common toxidromes and promptly use specific antidotes for the management of childhood toxidromes.

Keywords: antidote, extracorporeal treatment, intoxication, paediatric poisoning, toxidrome.

Citation: Hon KL, Hui WF, Leung AKC. Antidotes for childhood toxidromes. Drugs in Context 2021; 10: 2020-11-4. DOI: 10.7573/dic.2020-11-4

Contributions: KLH is the principal author. WFH and AKCL are coauthors who contributed and helped with the drafting of this manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: KLH and AKCL are associate editors of Drugs in Context and confirm that this article has no other conflicts of interest otherwise. This manuscript was sent out for independent peer review by the Managing Editor. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at:

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2021 Hon KL, Hui WF, Leung AKC. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Hon KL, Hui WF, Leung AKC. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

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Correspondence: Kam Lun Hon, 9/F, Tower B, Hong Kong Children’s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong SAR. Email:

Provenance: Invited; externally peer-reviewed.

Submitted: 19 November 2020; Accepted: 20 April 2021; Publication date: 2 June 2021.

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