University:
Boston University
Course:
CAS CH 524 | Chemical Biology Laboratory
Academic year:

2023
Views:

136

Pages:

25
Author:

Tara Guerrero

CYANIDE and Cyanide Antidote Package Cyanide is a highly reactive Chemical Uses: • Chemical synthesis, laboratory analysis • Plastic industry • Metal plating, mining, electroplating • Apricot pits, Cassava, and other seeds • Acetonitrile, artificial nail remover Cyanide is a highly reactive Chemical • Cyanide Is the Most Rapidly Lethal Poison Known to Man • Primary Mechanism of Action Is Blocking the Ability of Cells to Use Oxygen by Inactivating Cytochrome Oxidase (Aa3) and Cellular Respiration • Tissues With the Highest Oxygen Affinity Are Most Affected: Brian, Heart, Liver Hydrogen Cyanide Gas • Generated by mixing acid with cyanide salts • Common by product of burning plastics, wool or synthetic products • Hydrogen cyanide is used in deliberate suicide and homicide • Cause of death from structural fires Cyanide • State executions by the ancient Greeks, Romans, Californians. • The 1st chemist to synthesized HCN gas died in 1786 when a vial of the gas broke. • Mass suicide: in 1978 hundreds died in Jonestown, British Guiana. Mechanism of Toxicity • • • • Chemical Asphyxiant Blocks Cytochrome Oxidase Blocks the Aerobic Use of Oxygen Unbound Cyanide is Detoxified by Metabolism to Thiocyanate • Excreted in the Urine Examples of Cyanides • • • • Potassium Cyanide Sodium Cyanide Sodium Cyanoborohydride TMS Cyanide Toxic Dose of HCN • Even at low levels (150–200 ppm) can be fatal • Air level considered immediately dangerous to life and health is 50 ppm • The recommended workplace ceiling limit • ACGIH TLV–C is 4.7 ppm • Easily absorbed through intact skin Prevent Exposure • Prevent Dispersion of DUST! • STRICT HYGIENE • Avoid any skin or eye contact • Seek immediate medical attention if exposed Toxic Doses of Cyanide Salts NaCN/KCN • Ingestion of Cyanide salts may be fatal with as little as 200 mg • Solutions of Cyanide Salts can be absorbed through intact skin or through the conjunctiva of the eye Storage and Handling • • • • Work in a fume hood Wear Splash goggles Wear impermeable gloves Store Cyanide salts in a cool, dry place, away from acids • Reacts with acids to release cyanide gas Routes of Exposure • • • • Inhalation Skin Eye Ingestion Routes of Exposure Inhalation • Prevention • Work in chemical fume hood that has been tested • Air purifying or supplied air respirators available for emergencies when working with large quantities (several grams of cyanide compounds) • Any release outside the hood requires evacuation of the lab Routes of Exposure Skin • Immediately wash with soap and water • remove and isolate contaminated clothing Routes of Exposure Eye • Can absorb cyanide gas • Causes redness, pain, severe deep burns • In case of eye contact, wash promptly with water for 15 minutes lifting upper and lower lid occasionally Routes of Exposure Ingestion • Do not smoke, drink, eat or apply cosmetics during work • Wash hands before eating • Ingestion causes burning sensation, nausea, vomiting and diarrhea • Obtain medical attention immediately! • Medical treatment: activated charcoal, gastric lavage Clinical Presentation of Cyanide Poisoning Abrupt Onset of Profound Toxic Effects Is the Hallmark of Cyanide Poisoning Symptoms of Cyanide Poisoning Headache Nausea Dypsnea Confusion Syncope Seizures Coma Agonal Respirations Cardiovascular Collapse Physical Findings in Cyanide Poisoning • Generally non–specific • Despite poor perfusion , skin color may remain pink from high arterial and venous oxygen saturation and the reddish pigment of cyanhemoglobin • Cyanide has poor warning properties • Cherry red skin and smell of burnt almonds is inconsistent Contents Cyanide Antidote Package • 2 ampoules Sodium Nitrite Injection (300 mg in 10 ml of water/ a 3% solution) • 2 vials Sodium Thiosulfate Injection (12.5 g in 50 ml of water/ a 25% solution) • 12 ampoules Amyl Nitrite Inhalants Contents Continued Cyanide Antidote Package • Also: 10 mL plastic disposable syringe with a 22 gauge needle • 1 sterile 60 ml plastic disposable syringe • 1 sterile 20 gauge needle • 1 stomach tube • 1 non-sterile 60 ml syringe • 1 tourniquet • 1 set of instructions Actions 1 • Sodium Nitrite + Hemoglobin forms Methemoglobin (NaNO2 + Hemoglobin → Methemoglobin) • Methemoglobin has a greater affinity for CN than Oxyhemoglobin • Methemoglobin removes Cyanide ions from tissues and forms Cyanomethemoglobin, which has a relatively low toxicity. (HCN + Methemoglobin → HSCN) Actions 2 • Sodium Thiocyanate converts Cyanide to Thiocyanate by an enzyme, rhodanese • Na2S2O3 + HCN + O → HSCN • The combination of Sodium Nitrite and Sodium Thiosulfate are the best available treatment against cyanide and hydrocyanic acid poisoning When to Use a Cyanide Antidote Package • Without proper treatment cyanide poisoning may be rapidly fatal • Exposure followed by collapse, difficulty breathing, or bluish discoloration of the skin, indicates immediate need for treatment When to Use the Antidote Package Otherwise wait for Emergency Medical Services to arrive • Reason: Inability to treat low blood pressure that may result from the use of the Amyl Nitrite and the development of excessive methemoglobinemia • Nitrites might work through vasodilatation rather than formation of methemoglobin

Cyanide and Cyanide Antidote Package

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