Cyanide
David J. George in Poisons, 2017
The public is very much aware of the toxic potential of cyanide. During World War II, the Nazis used cyanide as an agent of genocide. Starting in the early 1920s, cyanide gas chambers were used for the execution of criminals sentenced to death in the United States. There was also a widely publicized mass suicide carried out in 1978 in Jonestown, Guyana by members of a religious organization utilizing a fruit-flavored cyanide drink; more than 900 cult members died, including men, women, and children. Exposures most commonly involve either hydrogen cyanide gas or potassium cyanide powder. Cyanide blocks the utilization of oxygen at the cellular level, resulting in metabolic asphyxiation. Early neurological manifestations of cyanide poisoning can include anxiety and confusion. The results from one laboratory were consistent with a cyanide poisoning cause of death; whereas the other laboratory's analytical results were more consistent with high normal cyanide levels.
Methylene Blue
James L. Schardein, Orest T. Macina in Human Developmental Toxicants, 2006
Methylene blue is a vital dye that has therapeutic utility as an antidote for cyanide poisoning and drug-induced methemoglobinemia. As a dye, it is also used as a marker in various tissues and amniotic fluid. The chemical is used in the latter to identify by amniocentesis midtrimester anatomic and pathologic structures in twin pregnancies, especially to diagnose premature rupture of membranes. Only one animal developmental toxicity study has been published following intra-amniotic (IA) injection of methylene blue. In the human, the use of methylene blue IA injections in pregnancy resulted in a number of case reports of malformation, as tabulated by >60 representative cases provided. Methylene blue is a positively charged human developmental toxicant. It is hydrophobic and of average size in comparison to the other compounds. It possesses a relatively low polar surface area. Methylene blue is a weak hydrogen bond acceptor.
Cyanide Poisoning
Charles Theisler in Adjuvant Medical Care, 2022
Cyanide poisoning is a condition that develops when a person inhales, touches, or swallows cyanide, which prevents the body from using oxygen. Smoke from fires or cigarettes can also cause cyanide poisoning.
A Case of Cyanide Poisoning and the Use of Arterial Blood Gas Analysis to Direct Therapy
Published in Hospital Practice, 2010
Christopher P. Holstege, Joseph D. Forrester, Heather A. Borek, David T. Lawrence
Cyanide poisoning is a difficult diagnosis for health care professionals. Existing reports clearly demonstrate that the initial diagnosis is often missed in surreptitious cases. The signs and symptoms can mimic numerous other disease processes. We report a case in which a suicidal patient ingested cyanide and was found unresponsive by 2 laboratory coworkers. The coworkers employed cardiopulmonary resuscitation with mouth-to-mouth resuscitation. The suicidal patient died shortly after arrival to the hospital, while the 2 coworkers who performed mouth-to-mouth resuscitation presented with signs and symptoms that mimicked early cyanide toxicity but were instead due to acute stress response. An arterial blood gas analysis may help aid in the diagnosis of cyanide toxicity. Electrocardiographic findings in a patient with cyanide poisoning range significantly, depending on the stage of the poisoning.
Carbon monoxide and cyanide toxicity: etiology, pathophysiology and treatment in inhalation injury
Published in Expert Review of Respiratory Medicine, 2013
Todd F Huzar, Tonya George, James M Cross
Inhalation injury is most commonly associated with damage to the mucosal surfaces of the small and large airways after exposure to smoke and other products of incomplete combustion. Yet, there are far deadlier things lurking within the smoke than just the heat and particulate matter: carbon monoxide and cyanide. These two toxic substances are found in varying concentrations within the fire room and are associated with early on-scene death and in-hospital morbidity and mortality. Patients suffering from carbon monoxide and/or cyanide poisoning present with vague symptoms requiring an astute physician to make the diagnosis. Fortunately, the toxic effects related to exposure to these agents can be reversed with readily available antidotes.
Visual loss caused by acute cyanide poisoning: A case report
Published in Clinical Toxicology, 2011
Fei Chen, Libin Jiang, Bentao yang
Context. Cyanide is considered one of the most lethal poisons, reports on visual changes after acute cyanide poisoning are rare due to a low rate of survival of those having committed suicides. Case details. A 30-year-old man developed visual loss in both eyes after inhaling sodium cyanide gas, but nothing abnormal was found in slit lamp microscope and indirect ophthalmoscope examinations 5 months later. In pattern visual evoked potential, the amplitude of P100 wave was apparently decreased. Humphrey perimetry examination and AccuMap multifocal visual evoked potentials objective perimetry showed severe defects of the central visual field. Magnetic resonance imaging revealed abnormal signal changes in bilateral putamen. Results of other examinations, including Farnsworth dichotomous color vision test, optical coherence tomography, retinal nerve fiber layer examination and flash electroretinography, were normal. Discussion. Although magnetic resonance imaging showed no changes in the signal of the visual pathway, clinical features and our test results suggest a possible lesion in the posterior visual pathway.
Related Knowledge Centers
- Apnea
- Cellular Respiration
- Paralysis
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- Vertigo
- Histotoxic Hypoxia
- Seizure