Antidotes sodium thiosulfate

B. Specific drugs and antidotes. Sodium thiosulfate may convert Iodine to Iodide and tetrathionate, but Is not recommended for intravenous use because iodine is rapidly converted to Iodide In the body. 

The antidote of choice for mechlorethamine extravasations is sodium thiosulfate. This agent binds alkylating agents, resulting in neutralization to inactive compounds that are then excreted. Sodium thiosulfate also may be effective for high-concentration cisplatin or dacarbazine extravasations. 

For cyanide and cyanogen, antidote should be administered as soon as possible. The Lilly Cyanide Antidote Kit contains amyl nitrite, sodium nitrite, and sodium thiosulfate. Cobalt edentate or 4-dimethylaminophenol are alternative antidotes for cyanide poisoning. Benzodiazepines or barbiturates may be required to control severe seizures. 

Antidotes Intravenous sodium nitrite and sodium thiosulfate, and/or amyl nitrite perles are packaged in the cyanide antidote kit. When possible, treatment with cyanide antidotes... 

The ability of cyanide to combine with carbonyl groups of some intermediary metabolites (e.g., sodium pyruvate, a-ketoglutarate) to form cyanohydrin has been used for antidotal purposes. Pretreatment of mice with 1 g/kg sodium pyruvate intraperitoneally prior to subcutaneous injection of potassium cyanide caused an increase in the LD50 values from 3.1 to 5 mg CN /kg (Schwartz et al. 1979). Sodium pyruvate also prevented the development of convulsions in cyanide-exposed mice. Similarly, intraperitoneal pretreatment of mice with 2 g/kg a-ketoglutarate before the intraperitoneal injection of potassium cyanide increased the LD50 value from 2.68 to 13.32 mg CN /kg (Moore et al. 1986). It was further demonstrated that both sodium pyruvate and a-ketoglutarate enhanced the antidotal effects of other cyanide antagonists (e.g., sodium thiosulfate, sodium nitrite) (Moore et al. 1986 Schwartz et al. 1979). 

Several papers discuss the effects of oxygen alone or with other compounds on cyanide toxicity. Oxygen alone results in minimal antagonism in mice injected with potassium cyanide and only slightly enhances the antagonistic effects of sodium nitrite (Sheehy and Way 1968). The antidotal effect of sodium thiosulfate alone or in combination with sodium nitrite, was enhanced by oxygen. 

Hume AS, Mozigo JR, McIntyre B, et al. 1995. Antidotal efficacy of alpha-ketoglutaric acid and sodium thiosulfate in cyanide poisoning. Clinical Toxicol 33(6) 721-724. 

Acute poisoning only occurs when the detoxification mechanism is overwhelmed. This reaction is enhanced by giving sodium thiosulfate and sodium nitrate intravenously as 20% solutions in a 3 1 ratio, which is a recommended antidote for acute cyanide poisoning. It is the thiocyanate metabolite that causes chronic disease when cyanide forage is ingested over an extended period. 

The compounding of poisoning antidotes, such as sodium nitrite, sodium thiosulfate, methylene blue, or calcium EDTA, was considered necessary. 

Note - It is a good idea to have a supply of cyanide antidote ready in case you are affected by the fumes. These are sodium thiosulfate, a common photographic chemical, and amyl nitrite, a heart drug. Butyl nitrite is available in some "sex" shops as a room odorant, and may be substituted for the amyl nitrite. A few hours before beginning production of the actual cyanide, take a capsule containing 500 mg of sodium thiosulfate. It is comparatively non-toxic, but may cause a small bout of "egg burps". 

Cyanide Antidote Kit (See Amyl Nitrate. Sodium Nitrite, and Sodium Thiosulfate) Rumazenil (Romazicon)... 

Potassium cyanide is a dangerously toxic substance. Ingestion of 100 to 150 mg can cause collapse and cessation of breathing in humans. At lower doses, the acute effects are nausea, vomiting, headache, confusion and muscle weakness (Patnaik, P. 1999. A Comprehensive Guide to the Hazardous Properties of Chemical Substances, ed. pp. 292-294. New York John Wdey Sons). Contact with acid can liberate highly toxic vapors of hydrogen cyanide. Sodium thiosulfate and sodium sulfate have shown antidotal activity to KCN toxicity. 

Sodium thiosulfate is a common analytical reagent used in iodometric titration to analyze chlorine, bromine, and sulfide. Other uses are in bleaching paper pulp, bleaching straw, ivory, and bones, for removing chlorine from solutions, silver extraction from its ores, a mordant in dyeing and printing textiles, and as an antidote to cyanide poisoning. 

Treatment of cyanide poisoning includes rapid administration of activated charcoal (although charcoal binds cyanide poorly, it can reduce absorption) and general supportive care. The conventional antidote kit available in the USA includes two forms of nitrite (amyl nitrite and sodium nitrite) and sodium thiosulfate. The nitrites induce methemoglobinemia, which binds to free CI T creating the less toxic cyanomethemoglobin thiosulfate is a cofactor in the enzymatic conversion of CN to the much less toxic thiocyanate (SCINT). Recently, the FDA approved a concentrated form of hydroxocobalamin, which is now available as the Cyanokit (EMD Pharmaceuticals, Durham, North Carolina). Hydroxocobalamin (one form of vitamin B12) combines rapidly with CN to form cyanocobalamin (another form of vitamin B12). 

It is extremely poisonous (antidote 10% sodium thiosulfate soln). It is used in agriculture as a fungicide, in org reactions as a catalyst, and its solns are used medicinally as an antiseptic... 

Cyanide poisoning is treated with attention to airway and cardiopulmonary management. Cyanide poisoning is treated with a specific antidote of amyl nitrite perles, sodium nitrite, and sodium thiosulfate. 

The cyanide antidote kit contains amyl nitrate, sodium nitrate, and sodium thiosulfate. Nitrates convert hemoglobin to methemoglobin, which in turn competes for cyanide with the mitochondrial oxidase complex. Amyl nitrate pearls, administered by inhalation, can be utilized as a first aid measure when intravenous (IV) access is impossible or will be delayed. If IV access is available, IV sodium nitrate is preferred, followed by sodium thiosulfate. Sodium thiosulfate reacts with cyanide to form nontoxic thiocyanate, which is then excreted into the urine. 

Cyanide is a nucleophile known to react with various carbonyl moieties like ketones and aldehydes to yield cyanohydrin derivatives (Morrison and Boyd, 1976). Sodium pyruvate (Schwartz et al, 1979), a-ketoglutarate (Moore et al, 1986), pyridoxal-5 -phosphate (Keniston et al, 1987), and many other carbonyl compounds and their metabolites or nutrients which interact with cyanide to form cyanohydrin complexes (Way, 1984 Niknahad et al, 1994 Bhattacharya and Tulsawani, 2008) have been reported to afford significant protection against acute cyanide poisoning in vitro or in vivo. Out of all these agents, a-ketoglutarate, either alone or with sodium thiosulfate, has been considered to be a promising antidote for cyanide (Borowitz et al. 

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