Cyanides poison treatment

Nagler, J., R.A.Provoost and G.Parizel. 1978. Hydrogen cyanide poisoning Treatment with cobalt EDTA. J. Occup. Med. 20(6) 414-416. 

Hyperbaric oxygen has no proven role in cyanide poisoning treatment. 

D. Enhanced elimination. There is no role for hemodialysis or hemoperfusion in cyanide poisoning treatment. Hemodialysis may be indicated in patients with renal insufficiency who develop high thiocyanate levels while on extended ni-troprusside therapy. 

Poison Treatment As discussed previously, methemoglobin binds well and competes with cytochrome oxidase for cyanide ions. Consequently, the antidote developed for cyanide poisoning involves increasing the formation of methemoglobin in the blood, by inhalation of amyl nitrate vapor (Chen 1952). Antidote kits contain amyl nitrate ampoules. To administer the antidote, the ampoule is broken in a cloth such as a handkerchief and held close to the victim s nose while artificial respiration is being conducted. Resuscitation by mouth is not recommended a mechanical resuscitator should be used instead. If the victim does not respond to the amyl nitrate treatment, a medical professional would then increase the methemoglobin production by intravenous injection of sodium nitrate followed by administration of thiosulfate to increase the activity of the rhodanese enzyme. 

Mandelic acid. This preparation is an example of the synthesis of an a-hydroxy acid by the cyanohydrin method. To avoid the use of the very volatile and extremely poisonous hquid hydrogen cyanide, the cyanohydrin (mandelonitrile) is prepared by treatment of the so um bisulphite addition compound of benzaldehj de (not isolated) with sodium cyanide ... 

In animals, deaths from acrylonitrile have been reported in several species following inhalation, oral or dermal exposure. In most species, death appears to be related to cyanide poisoning. That the cyanide moiety is involved in human toxicity of acrylonitrile has been reported in a case study in which a human male was sprayed with acrylonitrile when a valve burst (Vogel and Kirkendall 1984). This individual suffered symptoms characteristic of cyanide poisoning, and treatments designed to reduce cyanide levels in the blood were required in order to save his life. 

Treatment — Patients should be decontaminated immediately prior to treatment using the decontamination method presented in Section 7.3.3. The Lilly Cyanide Antidote Kit contains amyl nitrite, sodium nitrite, and sodium thiosulfate. Dimeth-ylaminophenol, cobalt-edetate, or vitamin B12a are alternative antidotes for cyanide poisoning.5... 

This section will describe clinical practice and research concerning methods for reducing toxic effects of exposure to cyanide. However, because some of the treatments discussed may be experimental and unproven, this section should not be used as a guide for treatment of exposures to cyanide. When specific exposures have occurred, poison control centers and medical toxicologists should be consulted for medical advice. The following texts provide specific information about treatment following exposures to cyanide ... 

PotterAL. 1950. The successful treatment of two recent cases of cyanide poisoning. BrJIndMed 7 125-130. 

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