Cyanide Antidote Kit

Cyanide Antidote Kit (Trade Name) / Classification

Cyanide Antidote Kit (Cyanide Antidote Package) / Antidote

Cyanide Antidote Kit- Desired Effects

speeds breakdown and degradation of cyanide, a potent cellular toxin

Cyanide Antidote Kit- Mechanism of Action

A water soluble salt and reducing agent that reacts with oxidizing agents.

Although its exact mechanism of action is unknown, thiosulfate likely provides an exogenous source of sulfur, thereby hastening the detoxification of cyanide through the enzyme rhodanese (thiosulfate cyanide sulfurtransferase) which converts cyanide to the relatively nontoxic, excretable thiocyanate ion

Cyanide Antidote Kit- Indications

known or highly suspected significant cyanide ingestion or poisoning

Cyanide Antidote Kit- Contraindications

significant allergy to thiosulfate or nitrate

Cyanide Antidote Kit- Adverse Reactions

1. hypotension

2. nausea and vomiting

Cyanide Antidote Kit- Drug Interactions

Diazoxide may enhance the hypotensive effect of antihypertensives

Cyanide Antidote Kit- Precautions

smoke inhalation: use nitrites cautiously in patients with cyanide poisoning related to smoke inhalation because methemoglobinemia and carboxyhemoglobinemia may worsen oxygen carrying capacity

Cyanide Antidote Kit- Special Considerations

Amyl Nitrate ampules should be administered 30 seconds at a time alternating between ampules and 100% oxygen

Cyanide Antidote Kit- Dosing Regimen

• ADULT

  • Amyl Nitrate — inhalation

  • Sodium Nitrate — 10 ml IVP over 3 minutes

  • Sodium Thiosulfate — 50 ml IVP over 10 minutes

• PEDIATRIC

  • Amyl Nitrate — inhalation

  • Sodium Nitrate — 0.2 ml/kg IVP over 3 minutes

  • Sodium Thiosulfate — 0.8 ml/kg IVP over 10 minutes

Cyanide Antidote Kit- Protocol Location

toxic exposure - cyanide exposure