<b>Antidote Availability and Community Pharmacist Preparedness for Acute Poisoning Management: A Cross-Sectional Knowledge, Attitudes, and Practices Study in Lahore, Pakistan</b>

Background: Acute poisoning is a preventable public health emergency requiring timely recognition, referral, and access to appropriate antidotes. Community pharmacists may serve as accessible first-contact healthcare providers, but their preparedness for poisoning management in Pakistan remains underexplored. Objective: To assess antidote availability and community pharmacists’ knowledge, attitudes, and practices regarding acute poisoning management in Lahore, Pakistan. Methods: A cross-sectional survey was conducted among 102 community pharmacists using a structured questionnaire. Antidote availability was assessed across 19 selected antidotes and categorized as good when ≥12 antidotes were stocked. Knowledge was assessed using five poisoning scenarios and categorized as good when ≥3 responses were correct. Descriptive statistics and chi-square testing were performed using SPSS version 26.0, with p < 0.05 considered statistically significant. Results: All pharmacies had poor antidote availability, with no stocking ≥12 antidotes. Sodium bicarbonate was most available (56.9%), while naloxone and atropine were available in only 16.7% and 36.3% of pharmacies, respectively. Overall, 80.2% of pharmacists had poor antidote knowledge, and professional experience was not significantly associated with knowledge category (p = 0.876). Only 20.6% had received formal poisoning-management training, although 87.2% supported ongoing training and 90.2% supported collaboration with poison control centers. Conclusion: Community pharmacies in Lahore are insufficiently prepared for acute poisoning response, requiring structured training, minimum antidote stocking policies, and integration with poison control networks.