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9 Cards in this Set

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What is the trade name for hydroxocobalamin used as an antidote?
Cyanokit
Unlike most other therapeutic uses of hydroxocobalamin, the Cyanokit uses IV administration.
What is the functional class of hydroxocobalamin?
- Vitamin
- Antidote
Hydroxocobalamin is one vitamer of vitamin B12. The others include cyanocobalamin, methylcobalamin, and adenosylcobalamin.
What is the mechanism of action of hydroxocobalamin?
Hydroxocobolamin is the precursor to vitamin B12 (cyancobolamin). When exposed to hydroxocobolamin, the cyanide attaches itself to form vitamin B12. It is then safely excreted in the urine.
All of the vitamers of B12 have vitamin activity.
What are the listed indications for hydroxocobalamin?
Treatment of known or suspected cyanide poisoning
In addition to some pesticides and insecticides, cyanide is contained in tobacco smoke and smoke from building fires.
What are the listed contraindications for hydroxocobalamin?
Hypersensitivity to any component of the medication (including cobalt)
Cobalamins contain a single cobalt atom in the nucleus of each molecule.
What are the listed precautions for hydroxocobalamin?
Transient severe hypertension secondary to infusion
Administration of hydroxocobalamin may interfere with some clinical laboratory evaluations.
What are the listed side effects for hydroxocobalamin?
- Hypertension
- Pruritis
- Headache
- Chromaturia (up to 5 weeks)
Hematochezia can also occur.
What are the listed interactions for hydroxocobalamin?
Due to incompatibilities (particulate formation), the following medications need to be run through different tubing (separate from hydroxocobolamin):
- Diazepam
- Dobutamine
- Dopamine
- Fentanyl
- Nitroglycerin
There are very few interactions that occur in vivo, as opposed to during delivery.
What is the dosage and route of hydroxocobalamin?
Adult:
-1 kit (5g) infusion over 15 minutes. May repeat giving 1 additional kit (5g) over 15 minutes to 2 hours if needed based on symptoms.

NOTE: Kit must be given immediately if poisoning is suspected!

Administration Procedure (per kit)
1) Reconstitute both of the 2.5g vials with 100ml NS
2) Repeatedly invert vial for 30 seconds to reconstitute; Do not shake!
3) Administer contents of first vial (2.5g) over ~7.5 minutes
4) Administer contents of second vial (2.5g) over ~7.5 minutes
Total doses up to 20g have been used.