Cyanide Antidote Pack

From Anvita Health Wiki

Contents 1 Indications 2 Dosage 3 Pharmacokinetics 4 Adverse-effects 5 Mechanism-of-action 6 More General Terms 7 Additional Terms 8 References

Indications

• antidote to cyanide poisoning

Dosage

• 1st sodium nitrite 300 mg (10 mL) IV
• 2nd sodium thiosulfate 12.5 grams (50 mL) by slow IV push

• repeat with 1/2 the dose as needed

• 3rd amyl nitrite: inhale 1-6 times using 0.3 mL inhalants

• repeat every 3-5 minutes as needed

• Kit contains:

• sodium nitrite 300 mg/10 mL ampules
• sodium thiosulfate 12.5 grams/50 mL ampules
• amyl nitrite 0.3 mL ampules
• stomach tube
• syringes & needles

Pharmacokinetics

• sodium thiosulfate

• distributes to extracellular fluid
• 1/2life 30-40 minutes
• excreted unchange in the urine

• amyl nitrite inhalation:

• onset of action 30 seconds
• duration of action 3-5 minutes

Adverse-effects

• tachycardia
• hypotension
• dizziness
• headache
• skin flushing
• palpitations
• nausea
• diarrhea

Mechanism-of-action

• sodium thiosulfate used with sodium nitrite increases cyanide detoxification by sulfur donation to rhodanese, with conversion of cyanide to non-toxic thiocyanate
• amyl nitrite oxidizes hemoglobin to methemoglobin with resultant formation of cyanomethemoglobin

More General Terms

• antidote
• pharmacologic combination

Additional Terms

• CN- (cyanide)
• methemoglobin (MetHb, Hi)
• thiosulfate sulfurtransferase; rhodanese (TST)

References

1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
3. Department of Veterans Affairs, VA National Formulary

cyanide antidote pack