An average of 4 animals per point was used. ![]() The data are plotted as durations of righting recovery timed from injections of toxin (not durations between successive rightings). Each time the mice righted they were turned on their backs again immediately and the times at which they righted (3 times per mouse) were recorded. Following the administration of toxin (t = 0) mice were then given (t = 2 min) aqueous NaNO 2 (0.17 mmol/kg, see columns 1,4,7), isoamyl nitrite in propylene glycol (0.17 mmol/kg, see columns 2,5,8), 3-methyl-1-butanol in propylene glycol (0.17 mmol/kg, see insert), or aqueous NaNO 2 + 3-methyl-1-butanol (0.17 mmol/kg each, see columns 3,6,9) and, subsequently, placed on their backs. ![]() B: Mice (Swiss-Webster males, 16-20 weeks of age) given NaCN in saline (5 mg/kg, i.p.). doses (0.17 mmol/kg NaNO 2 or isoamyl nitrite) then blood drawn by cardiac puncture and cryopreserved in EPR tubes. Swiss-Webster (males, 16-20 weeks of age ) mice were sacrified (CO 2) 10 min after i.p. Plausible explanations for these effects in mice and their practical consequences in relation to testing putative cyanide antidotes are discussed.Ī: EPR spectra (x-band, 20 K) of mouse blood obtained comparing NO formation secondary to NaNO 2 or isoamyl nitrite. Finally, working at slightly greater than LD50 NaCN doses, it was fortuitously discovered that (i) anesthesia leads to significantly prolonged survival compared to that of unanesthetized animals and that (ii) the antidotal activity of nitrite anion was completely abolished under anesthesia. It is argued that administration of an effective inhaled aqueous sodium nitrite dose in humans is possible, though just beyond the capability of current individual metered-dose inhaler designs, such as those used for asthma. The aerosol delivery was performed in an unmetered inhalation chamber, and in this study, no attempt was made to optimize the procedure. The inhaled sodium nitrite led to the production of NO in the bloodstream as determined by the appearance of EPR signals attributable to nitrosylhemoglobin and methemoglobin. Aerosolized sodium nitrite has thus been shown by these experiments to have promise as a better alternative to organic nitrites for development as an inhaled cyanide antidote. Subsequently, inhaled aqueous sodium nitrite aerosol was demonstrated to ameliorate sublethal cyanide toxicity, when provided to mice after the toxic dose, by the more rapid recovery of righting ability compared to that of the control animals given only the toxicant. Righting recovery from the knockdown state was clearly compromised in the isoamyl nitrite-treated animals, the effect being attributable to the toxicity of the isoamyl alchol produced during hydrolysis of the isoamyl nitrite to release nitrite anion. To facilitate a quantitative comparison, doses of both sodium nitrite and isoamyl nitrite were given intraperitoneally in equimolar amounts to sublethally cyanide-challenged mice. Inject sodium thiosulfate IV 7 g/sq.meter over 10 minutes not to exceed 12.Isoamyl nitrite has previously been considered acceptable as an inhaled cyanide antidote therefore, the antidotal utility of this organic nitrite compared with sodium nitrite was investigated. ![]() ![]() Many clinicians will administer only sodium thiosulfate portion if concerned of concomitant carboxyhemoglobinemia, or if ingestion is uncertainĪdminister amyl nitrite as in adults crush 0.3 mL ampul of amyl nitrite q1min and inhale vapor for 15-30 seconds until IV sodium nitrite infusion availableįollow amyl nitrite administration with sodium nitrate 10 mg/kg (0.33 mL/kg or 6-8 mL/sq.meter of 3% solution not to exceed 10 mL) Vasopressors should be available to treat shockĬurrently manufactured by Akorn, Inc, Buffalo Grove, IL (1-80) amyl nitrite inhalant: 0.3mL (12 ampules)Ĭrush 0.3 mL ampul of amyl nitrite q1min and inhale vapor for 15-30 seconds until IV sodium nitrite infusion availableįollowing infusion of 300 mg or 10 mg/kg IV sodium nitrate, over 2-5 minutes, inject 12.5 g sodium thiosulfate IV over 10 minutes PRN may repeat both injections at 1/2 original dose.sodium thiosulfate injection: 12.5g/50mL (2 vials).Dosing and uses of Cyanide antidote kit (sodium thiosulfate, sodium nitrite, and amyl nitrite)ĭiscontinued from United States market May 2012
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