Disease Information for Cyanide/Hydrogen cyanide exposure/poisoning: Definition

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  • Clinically severe metabolic acidosis, seizures followed by respiratory and vascular collapse; good color but global hypoxia effects;While liquid cyanide can be absorbed through the skin or eyes, the primary route of exposure is by inhalation or ingestion; Following absorption, cyanide is distributed rapidly to all organs and tissues in the body; Cyanide combines with ferric iron in cytochrome a3 (a component of the cytochrome oxidase complex in mitochondria) and inhibits this enzyme; This prevents intracellular oxygen use and results in imbalance between ATP hydrolysis and production; Metabolic acidosis is a hallmark of cyanide toxicity; It develops as cells are forced to use anaerobic metabolism and accumulate hydrogen ions and lactate; Cyanide blocks cytochrome oxidase at mitochondria level; interfers with cellular oxidation; essential anaerobic metabolism ensues leading to global hypoxic death and severe lactic acidosis; usually lethal but specific Lily or Pasadena cyanide kit can treat early; amyl nitrite, sodium nitrite THEN sodium thiosulfate; massive doses of vitamin B12 (hydroxcobalamine) have been successful (Cyomin)

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