Dosing recommendations for humans have been based on theoretical calculations of antidote detoxifying potential, extrapolation from animal experiments, and a small number of human case reports. Nearly all the human data describing the use of sodium thiosulfate report its use in conjunction with sodium nitrite. There are no randomized controlled clinical trials. The human data supporting the use of sodium thiosulfate and sodium nitrite for cyanide poisoning consists primarily of published case reports. The expert advice of a regional poison control center may be obtained by calling 1-80. Airway, ventilatory and circulatory support, and oxygen administration should not be delayed in order to administer sodium nitrite and sodium thiosulfate. Administration of sodium nitrite and sodium thiosulfate should be considered adjunctive to appropriate supportive therapies. Because of these risks, sodium thiosulfate and sodium nitrite should be used with caution in patients where the diagnosis of cyanide poisoning is uncertain.Ĭomprehensive treatment of acute cyanide intoxication requires support of vital functions. Sodium nitrite causes hypotension and methemoglobin formation, which diminishes oxygen carrying capacity. If clinical suspicion of cyanide poisoning is high, administer sodium thiosulfate and sodium nitrite without delay and in conjunction with appropriate airway, ventilatory, and circulatory support. Sodium thiosulfate 250 mg/mL injection is indicated for sequential use with sodium nitrite for treatment of acute cyanide poisoning that is judged to be serious or life-threatening. Uses for Sodium Thiosulfate (Antidote) (Systemic) Acute Cyanide Poisoning Sodium thiosulfate is a cyanide antidote. Sodium Thiosulfate (Antidote) (Systemic) (Monograph)Ĭhemical name: dioxido-oxo-sulfanylidene-lambda6-sulfane
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