scholarly journals Is There An Ideal Prehospital Drug Treatment For Acute Cyanide Poisoning?

2015 ◽  
Vol 12 (3) ◽  
Author(s):  
Craig B Barraclough

IntroductionCyanide, due to its toxicity and prevalence in a variety of industries, is a suitable agent for terrorists or disaffected persons to use as a weapon of terror. New Zealand’s National Poisons Centre lists five cyanide antidotes. This review aimed to identify whether there is an ideal pre-hospital drug treatment for acute cyanide poisoning.MethodsLiterature less than 10 years old was selected after a keyword search. The articles were reviewed for specific positive and negative properties of each antidote.ResultsThirty-nine articles were reviewed of which four were excluded. Results varied, with hydroxocobalamin scoring highly on effectiveness, with limited negative effects. It also demonstrated positive haemodynamic effects, suitability in cases involving trauma, carbon monoxide (CO), smoke inhalation casualties and was safe for pre-hospital use. Sodium nitrite, followed by dicobalt edetate had the next highest scores for efficacy. However, both scored negatively for their effects on blood, causing hypotension and toxicity, and they are unsuitable for trauma, CO or smoke inhalation casualties. Sodium thiosulphate, with a moderate level of efficiency, remained most effective when co-administered with other antidotes. 4-dimethylaminophenol and amyl nitrite rated the lowest, with negative effects similar to sodium nitrite. Adrenaline was tested as an antidote in one study where two novel antidotes both demonstrated promising results.ConclusionHydroxocobalamin had the highest success rate and its safety profile make it the most suitable pre-hospital drug treatment for acute cyanide poisoning.

2014 ◽  
Vol 25 (10) ◽  
pp. 797-803
Author(s):  
Yasumasa Iwasaki ◽  
Akira Narame ◽  
Kazunobu Une ◽  
Kohei Ota ◽  
Yoshiko Kida ◽  
...  

2013 ◽  
Vol 39 (3) ◽  
pp. 373-381 ◽  
Author(s):  
Ana Carolina Pecanha Antonio ◽  
Priscylla Souza Castro ◽  
Luiz Octavio Freire

In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection


1999 ◽  
Vol 18 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Ewa Florek ◽  
Andrzej Marszalek

1 The aim of this study was to evaluate the toxicological influence of tobacco smoke on fertility and reproduction of Wistar female rats. The influence of tobacco smoke from the Polish ‘Popularne’ cigarette brand was studied. The experiment was conducted on three generations of animals, each generation having two litters. The initial number of animals of the parent generation FO was 192 (128 females and 64 males). Animals were passively exposed to tobacco smoke in three different concentrations based on the content of carbon monoxide (500, 1000 and 1500 mg of CO per cubic meter of air). Animals were exposed to tobacco smoke for 6 h a day, 5 days a week, during 11 weeks. 2 The analysis of indices of mating and fertility revealed the decrease in those indices with animals exposed to tobacco smoke. We also observed an increased number of mothers breading among animals exposed to tobacco smoke. In animals exposed to tobacco smoke, the dose-effect or dose-response dependencies for mating, fertility and delivery indices were found. There was no influence of tobacco smoke on the duration of pregnancy. 3 Tobacco smoke inhalation caused increased levels of carboxyhaemoglobin. 4 Tobacco smoke did not change the duration of pregnancy in rats.


2010 ◽  
Vol 46 (4) ◽  
pp. 259-264 ◽  
Author(s):  
Marc Kent ◽  
Kate E. Creevy ◽  
Alexander deLahunta

Three adult Chihuahuas were presented for evaluation after smoke inhalation during a house fire. All three dogs received supportive care and supplemental oxygen. After initial improvement, the dogs developed seizures. Despite anticonvulsant therapy and supportive care, the dogs died. The brains of two dogs were examined. Lesions were identified that were compatible with acute carbon monoxide (CO) toxicity. Lesions were confined to the caudate nucleus, the globus pallidus, and the substantia nigra bilaterally, as well as the cerebellum, cerebral cortex, and dorsal thalamus. This case report describes the clinicopathological sequelae in acute CO toxicity.


2021 ◽  
Vol 14 (3) ◽  
pp. e239523
Author(s):  
Joshua Mastenbrook ◽  
Rachel Zamihovsky ◽  
Nathan Brunken ◽  
Thomas Olsen

Smoke inhalation is the most common cause of acute cyanide poisoning in the developed world. Hydroxocobalamin is an antidote for cyanide poisoning. There is little published about human intraosseous antidote administration. We present a case of intraosseous hydroxocobalamin administration in an adult smoke inhalation victim, found in cardiac arrest inside her burning manufactured home. Return of spontaneous circulation was achieved after 20 min of cardiopulmonary resuscitation. Five grams of hydroxocobalamin were subsequently given intraosseously. On hospital arrival, patient was found to have a respiratory-metabolic acidosis. She had red-coloured urine without haematuria, a known sequela of hydroxocobalamin administration. Patient’s neurological status deteriorated, and she died 4 days after admission. This case highlights that intraosseously administered hydroxocobalamin seems to adequately flow into the marrow cavity and enter the circulatory system despite the non-compressible glass antidote vial. This appears to be only the second reported human case of intraosseous hydroxocobalamin administration.


2012 ◽  
Vol 550-553 ◽  
pp. 2801-2804
Author(s):  
Peng Fu ◽  
Sen Meng An ◽  
Wei Ming Yi ◽  
Xue Yuan Bai

The thermodynamics of acetic acid steam reforming (AASR) for hydrogen production were simulated using a Gibbs free energy minimization method to study the influences of pressure, temperature and water to acetic acid molar feed ratios (WAFR) on the AASR. On the basis of the equilibrium calculations, the optimal operating conditions obtained were 700-800 oC, 1bar and WAFR = 6-10. At these conditions, the yield and selectivity of hydrogen were maximized and the formation of methane and coke was almost inhibited. Higher pressures had negative effects on the yields and selectivities of hydrogen and carbon monoxide. With increasing temperature from 300 to 1000 oC, the selectivity for hydrogen and carbon monoxide increased significantly along with a reduction in methane selectivity. Increase in the WAFR led to the increase in hydrogen selectivity and the decrease in carbon monoxide selectivity.


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