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8 Cards in this Set
- Front
- Back
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Pharmacology & Actions
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A. Cyanote is the trade name for Hydroxocobalamin.
-active ingredient is precursor of B12 -binds directly to cyanide ions, creating cyanocobalamin, a natural form of vitamin B12 which is excreted in urine B. Cyanide is an extremely toxic poison, death within minutes -inhibits mitochondrial function, specifically cytochrome oxidase resulting in arrest of cellular respiration |
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Indications
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A. suspect cyanide poisoning in any person exposed to smoke from a fire in a closed space and any other smoke inhalation victims with soot in the mouth or an altered mental status and low blood pressure.
B. known chemical exposure to cyanide containing chemicals |
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S/S of cyanide poisoning early
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-giddyness
-headache -vertigo -confusion -drunken behavior -shortness of breath |
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S/S advanced poisoning
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-N/V
-chest tightness -generalized seizures -coma -mydriasis (excessive dilation of pupils) -cardiac arrhythmias -hypertension (early) / Hypotension (late) -asystole -apnea -noncardiac pulmonary edema |
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other more specific findings (not always present)
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Normal-to-pink skin color (due to high arterial and venous levels of O2 in the presnce of the ceullar inability to utilize oxygen
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Precautions and Side Effects
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A. Cyanokit's most common adverse reactions (>5%) are
-transient and include chromaturia (red-colored urine) -erythema (skin redness) -rash -increased blood pressure -N -H/A -decreased lymphocyte percent -injection site reactions B. BP increases: substantial increases in blood pressure may occur following cyanokit therapy C. Particulate formation has been noted with admin with some other drugs such as Fent, Nitro, Dopamen, Diazepam, Pentobarbital, start a seperate IV |
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Admin Adults
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Adult
STANDING ORD 1. 5g (two 2.5g vials). take two 2.5 g vials and add 100 mL of NS to each vial. administer these two vials by IV over 15 minutes (15 mL/min) 2. Recommended diluent is 100 mL of 0.9% sodium chloride injection, although 100 mL LR or 5% D5W 3. Depending on the severity and the clinical response, a second dose of 5g may be administered over an infusion rate of 15 min to 2 hours 4. monitor BP carefully 5. warn patients about skin color changes |
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Admin Peds
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PEDS
MD ORDER 1. Prepare dose as noted above and administer 70 mg/kg up to a max of 5g for patients weighing 35kg or less prepare only 1 vial |
