Cyanide 4-dimethylaminophenol

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. 

Christel, D., P. Eyer, M. Hegemann, M. Kiese, W. Lorcher, and N. Weger. 1977. Pharmacokinetics of cyanide in poisoning of dogs, and the effect of 4-dimethylaminophenol or thiosulfate. Arch. Toxicol. 38 177-189. 

Klimmek R, Roddewig C, Fladerer H, et al. 1983. Effects of 4-dimethylaminophenol, Co2EDTA, or NaN02 on cerebral blood flow and sinus blood homeostasis of dogs in connection with acute cyanide poisoning. Toxicology 26 143-154. 

Kruszyna R, Kruszyna H, Smith RP. 1982. Comparison of hydroxylamine, 4-dimethylaminophenol and nitrite protection against cyanide poisoning in mice. Arch Toxicol 49 191-202. 

Dimethylaminophenol cyanmethemoglohin. In the presence of sodium thiosulfate cyanide is excreted as thiocyanate... 

Marrs, T.C., Bright, J.E. (1986). Kinetics of methaemo-globin production (I). Kinetics of methaemoglobinaemia induced by cyanide antidotes, p-aminopropiophenone, p-hydroxyl aminopropiophenone or p-dimethylaminophenol after intravenous administration. Hum. Toxicol. 6 139 5. 

Weger, N.P. (1983). Treatment of cyanide poisoning with 4-dimethylaminophenol (DMAP) - experimental and clinical overview. Fundam. Appl. Toxicol. 3 387-96. 

Klimmeck, R., Faderer, M., and Weger, N., Circulation, respiration and blood homeostasis of dogs during slow cyanide poisoning and after treatment with 4-dimethylaminophenol or cobalt compounds. Arch. Toxicol., 3, 121-133, 1979. 

Bhattacharya R. 1995. Therapeutic efficacy of sodium nitrite and 4-dimethylaminophenol or hydroxylamine coadministration against cyanide poisoning in rats. Human Experimental Toxicology 14 29-33. 

Hydroxocobalamin (Cyanokit) has been the chelator of choice in Europe and Australia, and has been approved for use in the United States since 2007. It works by combining with cyanide to form cyanocobalamin (vitamin B12 Hall and Rumack, 1987). Hydroxocobalamin has been shown to reduce mortality in rats, mice, and beagles and has the advantage of producing neither methemoglobinemia nor hypotension, as sodium nitrite does (Hall and Rumack, 1987 Borron et al., 2006). Dicobalt-EDTA (Kelocyanor) and 4-dimethylaminophenol hydrochloride (4-DMAP) are other chelators available in Europe, Israel, and Australia, but not in the United States (Hillman et al., 1974 Weger, 1990). 

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