TY - CHAP M1 - Book, Section TI - Antidotes in Depth A1 - Howland, Mary Ann A2 - Hoffman, Robert S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Nelson, Lewis S. A2 - Goldfrank, Lewis R. PY - 2015 T2 - Goldfrank's Toxicologic Emergencies, 10e AB - Sodium nitrite is an effective cyanide antidote when administered in a timely fashion and followed by sodium thiosulfate, which acts in synergy. The utility of amyl nitrite, a volatile drug available in ampules that can be broken and administered by inhalation while sodium nitrite is being prepared to administer intravenously, is questioned.13 Although the exact mechanism of action of the nitrites is unclear, the production of methemoglobin is both therapeutic in cyanide poisoning and potentially life-threatening if nitrites are administered to a patient with impaired oxygen carrying capacity, from elevated concentrations of carboxyhemoglobin, methemoglobin, or sulfhemoglobin from any cause. In the latter cases, hydroxocobalamin and or sodium thiosulfate can still be administered intravenously without causing harm. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1108423241 ER -