Amyl Nitrate

Glucagon

Adrenaline

Dextrose 50%

Analgesic, antipyretic

Adsorbent

Vasodilator, Antidote

Platelet inhibitor, anti-inflammatory

Binds with hemoglobin to help biodegrade cyanide

Alpha and beta agonist Alpha-1 – systemic vasoconstriction Beta-1 – positive inotropic, chronotropic and dromotropic effects Beta-2 – Bronchial smooth muscle relaxation

Not precisely known, but evidence is that it acts to depress hyper stimulated labyrinthine functions or associated neural pathways. It is also thought to inhibit cholinergic stimulation in the vestibular and associated neural pathways.

Reduces production of thromboxane which mediates platelet aggregation.

Acute cyanide poisoning with impaired LOC

Pyrexic child, severe sepsis or septic shock

Anaphylaxis, status asthma and croup

Hypoglycemia

Hypersensitivity

Hypersensitivity to ASA or other NSAIDs, active peptic ulcers

If no concrete proof of cyanide poisoning

Hyperglycemia

Flammable, so remove all sources of ignition

Do not administer to patient with decreased LOC. If ipecac has been administered, wait 10 minutes.

Hepatic or Renal insufficiency

Asthma patient

Drowsiness

Nausea, vomiting, constipation, cramping, bloating

Drowsiness, dizziness, blurred vision, dry mouth, dry nose and bronchi, tinnitus

nausea/ vomiting, cramping may be seen in overdose in children and nothing noted in adults till liver function deterioration

Inhalation

PO

IM, IV

IM, SQ, Nebulized

Adult: 325-650 mg every 4-6 hours, not to exceed 4000 mg/24 hours, Pediatric: 10-15 mg/kg every 4-6 hours, not to exceed 5 doses in 24 hours

160 – 325 mg

12 years and older: 1 mg with repeat in 15 min as needed Under 12 years: 0.1 mg/kg to a max of 1 mg with repeat in 15 min as needed

0.2 – 0.3 mL inhaled for 15 – 30 sec with breaks for 15 – 30 sec. New ampoule every 3 min till arrival at emergency department

Onset: 5 – 10 min (SQ) Peak effects: Varies Duration: 5 – 10 min

Excreted in urine, crosses placenta Onset: Immediate (IV), 20-30 minutes (IM) Peak effects: Varies Duration: 3-6 hours

Onset: Immediate Peak effects: Varies Duration: Varies based on gastrointestinal function, will act until excreted

Onset: 10 – 30 sec Peak effects: 30 sec Duration: 3 – 5 min

1 mg/mL (requires reconstitution)

Premixed with water or sorbitol 25 g / 125 mL bottle (200 mg/mL) 50 g / 250 mL bottle (200 mg/mL)

0.2 or 0.3 mL glass ampoule

50 mg/ml

Always ensure that a blood glucose reading is obtained before administration Since tissue necrosis can occur if IV is interstitial, you must aspirate blood to ensure IV is patent prior to medication administration

Can be deactivated by alkaline solutions

Ineffective if glycogen stores are depleted

Only services that respond to industries where cyanide exposure can occur will stock drug Retraining and certification is required by a physician every 2 years