![]() ![]() Sodium thiosulfate is both efficient and safe, but acts with delay. smoke inhalation, we should take into account not only the efficiency of antidotes but also their safety. However, regarding the main clinical condition of cyanide poisoning, i.e. Sodium thiosulfate, methemoglobin forming agents and cobalt compounds act efficiently by complexing or transforming cyanide into non-toxic stable derivatives. Oxygen counteracts efficiently cyanide action at the mitochondrial level. Supportive treatment is efficient but does not modify the time course or the body burden of cyanide. Advanced life support includes mechanical ventilation, catecholamine and sodium bicarbonate infusion. Basic life support includes immediate administration of high flow of oxygen, airway protection and cardiopulmonary resuscitation. Decontamination should be adapted to the route of poisoning and never postpone supportive treatment. Conventional treatment of cyanide poisoning includes decontamination, supportive and specific treatment. This article reviews the literature on cyanide poisoning treatment. Our objective was to compare conventional treatments to hydroxocobalamin. However, therapeutic strategies are still debated. Many antidotes are available and efficient. A plasma lactate concentration > or = 10 mmol/L in fire victims without severe burns and > or = 8 mmol/L in pure cyanide poisoned patients is a sensitive and specific indicator of cyanide intoxication. The biological hallmark is lactic acidosis. Clinical features include coma, respiratory arrest and cardiovascular collapse. The availability of this method will allow easy and rapid diagnosis (within 15 min of exposure) of SM poisoning especially during the asymptomatic latency period (6-24 h post-exposure).Cyanide poisoning may result from different exposures: residential fires, industrial accidents, drug and plant intoxication. The LOD of the method was 0.1 μM, with a linear range from 0.5 -100 μM. Additionally, a rapid, simple, and direct GC-MS analysis technique for an important SM biomarker, sulfur mustard oxide (SMO), was developed and validated in swine plasma. To our knowledge, there are no studies done in identifying SM biomarkers in inhalation exposure. Preliminary data for correlation of two biomarkers to dose are also presented. In this report, we identified biomarkers that have the potential for correlation to inhalation dose. ![]() A major challenge in inhalation studies is the quantification of actual respiratory dose. Therefore, current investigations are underway which focus on understanding the inhalation toxicity of SM in order to develop effective therapeutic interventions. Although its exposure can result in wide range of toxic outcomes, airway injury leading to respiratory failure is the principal cause of mortality in victims. Sulfur mustard (SM) is the most utilized chemical weapon in modern history. The method described here allows further investigations of DMTS as a promising antidote for cyanide poisoning. The limit of detection (LOD) using this method was 0.06 μM with dynamic range from 0.5 – 100 μM. Hence, a stir bar sorptive extraction (SBSE) gas chromatography – mass spectrometry (GC-MS) method was developed and validated for the analysis of DMTS from rabbit whole blood. Although a validated analytical method to analyze DMTS is not currently available from any matrix, one will be vital for the approval of DMTS as a therapeutic agent against cyanide poisoning. Dimethyl trisulfide (DMTS), a sulfur donor that detoxifies cyanide by converting it into thiocyanate, is a promising next generation cyanide antidote. ![]() The current FDA approved antidotes for cyanide poisoning can be effective, but each suffers from specific major limitations. Cyanide poisoning by accidental or intentional exposure poses a severe health risk.
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