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Old 01-27-2014
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Default To treat cyanide poisoning use nitrites

"To treat cyanide poisoning use nitrites to oxidize hemoglobin to methemaglobin which bind cyanide allowing cyt C To function.."

FA 2013 PG 547
In this statemnt we are giving nitrites which form methemaglobin..So methemaglobin is good thing ??

P.S i read somewhere that we use thiosulfate for cyanide poisoning

Last edited by medicalbiology; 01-27-2014 at 02:29 AM.
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In this case, yes it is. The dose of nitrite administered dictates the amount of MetHb formation, preventing toxic levels of MetHb in the body. It's sort of the lesser of two evils: which would you prefer, have a bit of MetHb in your blood (which will be removed after 120 days when the RBCs are lysed) or die due to stoppage of ETC and TCA?
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Quote:
Originally Posted by medicalbiology View Post
"To treat cyanide poisoning use nitrites to oxidize hemoglobin to methemaglobin which bind cyanide allowing cyt C To function.."

FA 2013 PG 547
In this statemnt we are giving nitrites which form methemaglobin..So methemaglobin is good thing ??

P.S i read somewhere that we use thiosulfate for cyanide poisoning
Yes just did that question in uworld. It was about nitroprusside toxicity and the answer was u sulphur.
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Quote:
Originally Posted by medicalbiology View Post
"To treat cyanide poisoning use nitrites to oxidize hemoglobin to methemaglobin which bind cyanide allowing cyt C To function.."

FA 2013 PG 547
In this statemnt we are giving nitrites which form methemaglobin..So methemaglobin is good thing ??

P.S i read somewhere that we use thiosulfate for cyanide poisoning

i bet you read about thiosulfate for cyonide on the same 547 page, just a couple sentences later so we use both nitrites and thiosulfate
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Thanks guuys for your helpful replies
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Thanks guuys for your helpful replies
Normally when the body has cyanide be it from breakdown of drugs like nitroprusside or whatever source, the liver has an enzyme called rhodanase which converts cyanide to thiocyanate which is excreted in urine. Rhodanase does this by donating sulphur to cyanide to form thiocyanate.
however when body becomes overburdened with cyanide ( cyanide toxicity)
or cyanide poisoning then rhodanase is not able to do this job all by itself so we need to help it to work faster by supplying more sulphur and we give more sulphur in the form of thiosulfate which donates more sulphur to speed up the detoxification process of cyanide.

So u either give nitrite to form the methemoglobin pathway of clear all the cyanide form ur system with thiosulfate pathway
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Nesereso(hope i write your name correctly) thanks for wonderful reply...sometimes i think you are member of panel which makes usmle questions..
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Nitroprusside Cyanide Toxicity

hope it will help
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