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Find an article or report by keywords: Enter Search Phrase. Find an article or report or see all by area, author, or year:. Year Background Cyanide is a naturally occurring chemical, found in many plants, that has been used in conventional warfare and poisoning for 2 millennia. In , the Japanese cult Aum Shinrikyo placed cyanide in subway bathrooms.
Mechanism of Action and Toxicokinetics Cyanide poisons the mitochondrial electron transport chain within cells and renders the body unable to derive energy adenosine triphosphate-ATP from oxygen. Signs and Symptoms Cyanide kills quickly: death occurs within seconds of a lethal dose of cyanide gas and within minutes of ingestion of a lethal dose of cyanide salt.
Signs and symptoms of cyanide poisoning include the following: CNS : headache, anxiety, agitation, confusion, lethargy, seizures, and coma; Cardiovascular : decreased inotropy, bradycardia followed by reflex tachycardia, hypotension, and pulmonary edema; and Other : acute lung injury, nausea and vomiting, cherry-red skin color.
Countermeasures Before cyanide antidote can be administered, the patient must be removed from the cyanide-laden area, clothing removed, and skin washed with soap and water.
Cyanide Antidote Kit : This 3-component process comprising amyl nitrite, sodium nitrate, and sodium thiosulfate releases cyanide from cytochrome a3 by providing a target for which cyanide has a higher attraction. Amyl nitrite, contained in pearls that must be broken and inhaled, and IV sodium nitrate cause the formation of methemoglobin, for which cyanide has a high binding affinity.
Sodium thiosulfate provides a source of sulfur that the enzyme rhodanese-the major pathway for metabolism of cyanide-utilizes to detoxify cyanide.
Cyanide is contained in cigarette smoke and the combustion products of synthetic materials such as plastics. Combustion products are substances given off when things burn. In manufacturing, cyanide is used to make paper, textiles, and plastics.
It is present in the chemicals used to develop photographs. Cyanide salts are used in metallurgy for electroplating, metal cleaning, and removing gold from its ore. Cyanide gas is used to exterminate pests and vermin in ships and buildings.
If accidentally swallowed, chemicals found in acetonitrile-based products that are used to remove artificial nails can produce cyanide when metabolized by the body. Reports have indicated that during the Iran-Iraq War in the s, hydrogen cyanide gas may have been used along with other chemical agents against the inhabitants of the Kurdish city of Halabja in northern Iraq.
How you could be exposed to cyanide You could be exposed to cyanide by breathing air, drinking water, eating food, or touching soil that contains cyanide. Cyanide enters water, soil, or air as a result of both natural processes and industrial activities. When present in air, it is usually in the form of gaseous hydrogen cyanide. Smoking cigarettes is probably one of the major sources of cyanide exposure for people who do not work in cyanide-related industries.
How cyanide works The extent of poisoning caused by cyanide depends on the amount of cyanide a person is exposed to, the route of exposure, and the length of time that a person is exposed.
Breathing cyanide gas causes the most harm, but swallowing cyanide can be toxic as well. Cyanide gas is most dangerous in enclosed places where the gas will be trapped.
Cyanide gas evaporates and disperses quickly in open spaces, making it less harmful outdoors. Cyanide gas is less dense than air; so it will rise. Cyanide prevents the cells of the body from using oxygen. When this happens, the cells die. Eating or drinking cyanide-containing foods may cause health effects. Breathing cyanide gas, especially in a poorly ventilated space, has the greatest potential for harm.
Lethal exposures to cyanides result only from accidents or intentional acts. Because of their quick-acting nature, cyanides may be used as agents of terrorism. After exposure, cyanide quickly enters the bloodstream. The body handles small amounts of cyanide differently than large amounts.
In small doses, cyanide in the body can be changed into thiocyanate, which is less harmful and is excreted in urine. In the body, cyanide in small amounts can also combine with another chemical to form vitamin B 12 , which helps maintain healthy nerve and red blood cells.
Large doses of cyanide prevent cells from using oxygen and eventually these cells die. The heart, respiratory system and central nervous system are most susceptible to cyanide poisoning. The health effects from high levels of cyanide exposure can begin in seconds to minutes. Some signs and symptoms of such exposures are:. The severity of health effects depends upon the route and duration of exposure, the dose, and the form of cyanide.
Moving away from the point of exposure to fresh air is an important first step in treating cyanide exposure. Cyanide poisoning can be further treated by medical professionals. Often patients are given oxygen. Two antidotes sodium nitrite and sodium thiosulfate are usually used to stop the effects of serious cyanide poisoning. Other drugs may be necessary to control additional health effects of cyanide such as seizures.
People who experience serious signs and symptoms will need immediate hospital care, especially individuals who have "passed out" or are unconscious. Any delay could result in death. While an elevated blood cyanide concentration may indicate that someone has been exposed to cyanide, laboratory testing for cyanide exposure will not be useful in making emergency treatment decisions. Cyanide can refer to any chemical that contains a carbon-nitrogen CN bond, and it can be found in some surprising places.
You can also find cyanide in certain nitrile compounds used in medications like citalopram Celexa and cimetidine Tagamet. Cyanide is even a byproduct of metabolism in the human body. These forms can appear as solids, liquids, or gases. Symptoms of toxic cyanide exposure may appear within a few seconds to several minutes after exposure. You may experience:. There are two different ways you can experience cyanide exposure. Acute cyanide poisoning has immediate, often life-threatening effects.
Chronic cyanide poisoning results from exposure to smaller amounts over time. Acute cyanide poisoning is relatively rare , and the majority of cases are from unintentional exposure.
If you suspect that you or a loved one is experiencing acute cyanide poisoning, seek immediate emergency medical attention. This condition is life-threatening. Cyanide poisoning is rare. You may be at risk for accidental exposure if you work in certain fields.
Many inorganic cyanide salts are used in the following industries:. After discussing your symptoms, your doctor will perform a physical exam. The first step to treating a suspected case of cyanide poisoning is to identify the source of exposure.
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