RT Book, Section
A1 Howland, Mary Ann
A2 Hoffman, Robert S.
A2 Howland, Mary Ann
A2 Lewin, Neal A.
A2 Nelson, Lewis S.
A2 Goldfrank, Lewis R.
SR Print(0)
ID 1108423241
T1 Antidotes in Depth
T2 Goldfrank's Toxicologic Emergencies, 10e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071801843
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1108423241
RD 2024/04/16
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.