9/5/2023 0 Comments Sodium thiosulfate antidoteThe cyanide bound to cytochrome oxidase is then preferentially bound to methemoglobin, forming cyanomethemoglobin. Intravenous sodium nitrite produces significant methemoglobinemia. Although there is no rapid test for the diagnosis of cyanide poisoning, an elevated lactate concentration (>8 mmol/L, or 72 mg/dL) and a venous blood gas with a high partial pressure of oxygen and a high oxygen saturation are, in the appropriate clinical context, highly suggestive of cyanide toxicity and warrant empiric antidotal therapy. Cyanide exposure causes rapid, severe systemic toxicity and rapid cardiovascular collapse. Cyanide overdose has been reported among workers in the gold, jewelry, and textile industries, in which the salts are frequently used. Suicide attempts involving the ingestion of commercially available cyanide salts have been reported. Smoke inhalation is one of the more common sources of exposure to cyanide in the United States. Cyanide also preferentially binds to the ferric ion of methemoglobin, but endogenous concentrations of methemoglobin are quite low.Įxposure to cyanide can occur during house fires, industrial accidents, and attempted suicides, and cyanide is a potential agent of chemical warfare. Cyanide binds to the ferric ion on cytochrome oxidase and abruptly halts the electron transport chain and aerobic respiration, producing profound toxic effects.
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