Clinical Guidelines, Standards & Quality of Care.Health & Safety in the Home, Workplace & Outdoors.Birth, Death, Marriage & Divorce Records.I am interested in any questions you would like answered in the Question of the Week. Jeff Guy, Chief of the Vanderbilt Burn Unit, recommends that hydroxocobalamin (Cyanokit) be administered in burn patients with the following: previously entrapped CO greater than 10% in nonsmokers burns to the face burns to the chest change in character of voice, or difficulty with secretions.Ĭlinical signs and symptoms of Cyanide toxicity will be discussed in the next Question of the Week. The problem is there is no quick test to determine which burn victims with smoke inhalation also have cyanide poisoning.ĭr. One of the main sources of cyanide poisoning is burning plastics, a material that burns in most house fires. The real use for this kit is going to be in the field and in the ED. The previous Lily Cyanide kit used agents that induced methemoglobinemia, so there was the potential to increase the hypoxia. Side effects have included allergic reactions, rash, red urine, increased blood pressure, and injection site reactions. Cyanokit is administered intravenously over 15 minutes. Each hydroxocobalamin molecule binds one cyanide ion. Signs and symptoms of acute cyanide poisoning may develop within minutes.Īdministration of cyanokit (hydoxocobolamin) to cyanide-poisoned patients results in formation of cyanocobalamin which is excreted in the urine. Inhibition of this cytochrome prevents the cell from using oxygen and forces anaerobic metabolism, resulting in lactate production, cellular hypoxia, and metabolic acidosis. Cyanide binds rapidly with cytochrome a3 in the mitochondria. Inhalation, ingestion or dermal exposure to cyanide-containing compounds may cause cyanide poisoning. Cyanokit contains hydroxocobolamin, the hydroxylated active form of vitamin B 12 ,an antidote indicated for the treatment of cyanide poisoning.
Cyanokit was FDA approved about a month ago.
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