Effectiveness of intramuscularly administered cyanide antidotes on methemoglobin formation and survival

Journal of Applied Toxicology : JAT
J A Vick, J D Von Bredow

Abstract

Successful first aid therapy for cyanide intoxication is dependent upon immediate administration of antidotes which directly or indirectly interact with the cyanide ion to remove it from circulation. Owing to the severe respiratory, cardiovascular and convulsive episodes following acute cyanide intoxication, the most practical approach is to administer antidotes by intramuscular injection. Exceptionally rapid methemoglobin formers-hydroxylamine hydrochloride (HH) and dimethylaminophenol (DMAP)-are usually able to prevent the lethal effect of cyanide following intramuscular injections in doses sufficient to induce 20% methemoglobin (HH = 20 mg kg-1 and DMAP = 2 mg kg-1). Sodium nitrite, the methemoglobin inducer approved for military use, must be administered by intravenous infusion because it is not an effective cyanide antidote by the intramuscular route. In the normal unintoxicated animal an intramuscular injection of 20 mg kg-1 sodium nitrite will form 20% methemoglobin; however, in acute cyanide intoxication the associated severe bradycardia appears to limit the rate of absorption and thus the rapid formation of methemoglobin. If the bradycardia is prevented or reversed by atropine, the rate of absorption of sodium nitrite ...Continue Reading

Citations

Jun 25, 2010·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Gaurav MittalRahul Bhattacharya
Sep 1, 2006·Environmental Toxicology and Pharmacology·Bożena BukowskaWirgiliusz Duda
Nov 5, 1999·Journal of Applied Toxicology : JAT·M AdlerS S Deshpande
Jul 17, 2007·Toxicology in Vitro : an International Journal Published in Association with BIBRA·Bozena BukowskaWirgiliusz Duda

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