A review on antidotes in contemporary science and ayurveda

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Introduction
Agada Tantra is one of the eight branches of Ashtang Ayurveda, which deals with the treatment of various poisons. If we look at modern toxicology, it deals with a variety of poisons, including those with plant and animal origins as well as their management. Visha is the substance that, as soon as it enters the body, vitiates healthy dhatus or kills healthy individuals 2 , while Visha is the substance that brings sadness to the world 3 . An antidote is a chemical compound that blocks or reduces the effects of a poison 4 . The word for an antidote in Ayurveda is Prativisha. Prativisha is one of the Chaturvimshati upakramas, according to Charak. 5 In Ashtanga Sanghrah Uttara sthana 48th Adhyaya, Prativisha is explained in detail. After the fifth stage has ended and before the seventh stage has begun, if the effects of poisons have not subsided despite the use of medicinal hymns and medications, Prativisha must be administered with the patient's permission 6 . The poisons, in any form, may be inhaled or swallowed, absorbed through the skin after being implanted by stings, bites, or other wounds, or absorbed through the mucous membrane, which is thinner and more delicate. 7 According to Acharya Charaka, a Visha (poison) can turn into a very good oushadha if it is administered correctly, but an oushadha can also turn into poison if it is administered incorrectly. The ancient tradition of the vishavaidya sampradaya is described in Vishavaidyajyotsnika, along with a mantra chikitsa that was written in the regional language of Malayalam, reaffirming the book's relevance. Vishavaidyajyotsnika's name means "moonlight that gives the eternal happiness from heart" 8 . Basavarajeeyam is a well-known Ayurvedic treaty that is widely used by Ayurvedic physicians. In the 23rd chapter of "Visharoganidhanalakshana adhyaya," the author clearly mentions various poisons and their antidotes.

Aims and objectives
Review the effects of the antidote described in Visha in Ayurvedic texts as well as the contemporary antidote.

Definition of antidote
The drugs called antidotes are used to prevent or lessen the effects of poison. The term comes from the Greek Pharmacon, which means "remedy". They are also known as reversal agents.

Mechanical/ physical antidote 9
They either prevent the absorption of poisons or mechanically neutralise them.

Activated charcoal
It is a powder that is fine, black, odourless.
It works mechanically by adsorbing and retaining organic and, to a lesser extent, mineral poisons within its pores, delaying absorption from the stomach.
It is ineffective against corrosives, heavy metals, cyanide, hydrocarbons, and alcohol.
With 8 ml of diluent per g of charcoal, the initial dose is 60 to 100 g for adults and 15 to 30 g for children.
When a substance travels through the gastrointestinal tract, the pH of the environment changes, which may cause adsorption and the release of the harmful chemical.

Demulcents
These include things like milk, starch, egg white, mineral oil, milk of magnesia, aluminium hydroxide gel, etc. that form a protective coating on the gastric mucous membrane and prevent poisons from damaging it.

Bulky food
By trapping the glass powder's particles within its meshes, acts as a mechanical antidote and protects against damage caused by the sharp glass particles.

Chemical antidote 10 :
When exposed to poison, they counteract its effects by oxidising it or forming harmless or insoluble compounds. Examples are:  Common salt decomposes silver nitrate by direct chemical action, forming the insoluble silver chloride.  Albumin precipitates mercuric chloride.  Dialysed iron is used to neutralise arsenic.  Copper sulphate is used to precipitate phosphorus.  Potassium permanganate has oxidising properties.1:5000 solution is used in poisoning for opium and its derivatives, strychnine, phosphorus, hydrocyanic acid, cyanides, barbituric acid and its derivatives, atropine and other alkalis. When it reacts with the poison in the stomach, it loses its pink colour. The wash must be continued till the solution coming out of the stomach is of the same pink colour as the solution put in.  A solution of tincture iodine or Lugol's iodine 15 drops to half a glass of warm water precipitates most alkaloids, lead, mercury, silver, quinine and strychnine.  Tannic acid 4%, or tannin in the form of a strong tea or one teaspoonful of tannic acid in water tends to precipitate apomorphine, cinchona, strychnine, nicotine, cocaine, aconite, pilocarpine, lead, silver, aluminium, cobalt, copper, mercury, nickel and zinc.
 Alkalis neutralise acids by direct chemical action. It is safer to give little weak solution of an alkaline hydroxide, magnesia or ammonia. Bicarbonate should not be given, because of the possible risk of rupturing the stomach due to liberated C02.  Acids neutralise alkalis by direct chemical action. Only those substances which are by themselves harmless should be given, e.g. vinegar, lemon juice, canned fruit juice. Neutralisation of acids with alkali and vice versa should be avoided because exothermic reaction of neutralisation can cause additional injury. So called universal antidote consisting of a activated charcoal, or burnt toast 2 part, Magnesium oxide one part and tannic acid or strong tea one part is not recommended.

Physiological or pharmacological 11
They work on the body's tissues and cause symptoms that are completely different from those brought on by the poison. They are administered after some of the poison has entered the bloodstream.
By obstructing another's ability to act on tissue cells, nerve systems, or enzymes, these agents work on the antagonism principle.
Atropine and physostigmine are two true physiological antidotes because they both affect nerve endings and have opposing effects on heart rate, pupillary state, and glandular secretory activity.
Cyanides and amyl nitrite are two other examples.

Chelating agents 12
Chelating agents (metal complexing agents) are used to treat heavy metal poisoning. When compared to endogenous enzymes, they have a higher affinity for metals. The agent-metal complex is more water-soluble than the metal itself, resulting in greater renal excretion of the complex. They have the ability to form stable, soluble complexes with calcium and other heavy metals.

Prativisha
Prativisha is an antidote to visha.
It consists of just two words: Prati + Visha . 'Prati' means against and 'Visha' means those destroy body. The medication used to calm Visha Utpanna Lakashana is called prativisha. [13][14][15][16] By emesis or gastric lavage, the poison might not have been entirely eliminated.

Need of prativisha
The poison has already been absorbed.
The poison/toxin was introduced by means other than ingestion. [17][18]  When the poison's effect is not alleviated by Mantra-Tantra procedures and other Aushada Upakarma and medication management.  When Visha-Pidita has reached the 5 th Vega but has not yet reached the 7 th Vega. That is, either in the 6 th or 7 th Visha Vega.  In an emergency situation or when all other therapeutic options have been exhausted, the Prativisha should be administered.

Contraindications of prativisha 19
To determine if a person is poisoned or not.
Prativisha should not be used when the poison is localised to a small portion of the blood.
The use of Prativisha in a person who drinks Ruksha Aahar (dry food) causes visual problems, ear ache, and Vatavyadi.
Prativisha should not be taken during the rainy season or on cloudy days.
Those who are irritated and suffering from Pitta disorders.
Those who are dry (very thin) and in pain due to a key organ ailment.

Dose
For For Luta damsha 21 -External application after Pracchana karma

How does antidote works
A drug or procedure that neutralises a poison or its effects. An antidote may function by lessening or preventing the stomach's ability to absorb a poison. By taking a substance to neutralise an acid, for example, it may directly counteract its effects. Alternately, a poison may be blocked at its receptor by an antidote 22 . Antidotes work by a number of different mechanisms, including forming an inert complex with the poison, speeding up detoxification, slowing down the poison's conversion into a more toxic compound, competing with the poison for key receptor sites, blocking key receptors that mediate the toxic effects, and avoiding the poison's effects altogether 23 .

Ghee as an antidote
Ghee has been referred to as the preferred medication for treating poisons in ancient Ayurvedic texts. Ghee has characteristics similar to those of Oja, making it useful in poisoning, according to Charak 24 .
Ghee has the property of being a destroyer of poisons, according to Acharya Vagbhata. He also makes it clear that it is the best treatment for all types of poisonings 25 . As a result, ghee should be used either alone or in combination with other anti-poison medications to treat poisoning patients. In the case of Alark Visha and Vrischika Visha, Agnikarma with boiling ghee is also recommended as the specific treatment 26 .

Madhu as an antidote
According to Acharya Shushruta and Vagbhata, madhu has the quality of being a poison destroyer and is the best treatment for all types of poisonings, regardless of the patient's condition. 27,28

Swarna bhasma as a antidote
According to Acharya Bhavaprakash, swarna is the best Rasayan, Ojaskara, and is beneficial in both Visha conditions, namely Jangama Visha and Sthavara Visha. 30

Discussion
People have been exposed to poisoning on a daily basis since ancient times, which has resulted in major health problems. Antidotes are used in Ayurveda to treat poisoning. Antidotes are pharmaceuticals that stop the progression of negative health effects brought on by exposure to exogenous substances, such as drugs, metals, and poisons 31 . The usage of antidotes is dependent on the clinical indication and the product's availability. Plant, animal, and mineral products are readily available antidotes. The majority of the antidotes discussed in this literature are plant and animal items. Swarasa is commonly used as an antidote to plant products. Milk is commonly used as an antidote to animal products.
The probable mode of action of each antidote can function with the concept of incompatible action for each other, as we have seen in day-to-day practice, where we can observe alcoholic patients who drink too much alcohol and then use lemon juice to lower the toxicity of the liquor. Similarly, Neeri Root is used to treat Langali toxicity. We can use ethanol for methanol poisoning and other antidotes for research purposes. As a result, an attempt has been made to consolidate everything in one publication.

Conclusion
Ayurveda recognises the necessity of Prativisha (Antidote) in counteracting poisonous possessions. Visha has virtues such as Laghu, Aashu, Sukshma, Vyavayi, Vikashi, and others that will penetrate Sukshmatisukshma srotas and work fast. Ayurveda has described various antidotes that are widely available. The highest poisoning death rate in the world is seen primarily in lower socioeconomic strata, with minimal publicity for emergency treatment. This article has discussed various specific antidotes that are widely available. This is the time to stimulate additional research on the antidote, for new and improved antidotes, and its action in various modes of poisoning conditions.