Amyl Nitrate

Dextrose 50%

Adrenaline

Glucagon

Vasodilator, Antidote

Adsorbent

Analgesic, antipyretic

Platelet inhibitor, anti-inflammatory

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.

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

Binds with hemoglobin to help biodegrade cyanide

Reduces production of thromboxane which mediates platelet aggregation.

Pyrexic child, severe sepsis or septic shock

Acute cyanide poisoning with impaired LOC

Hypoglycemia

Anaphylaxis, status asthma and croup

Hypersensitivity

Hyperglycemia

Hypersensitivity to ASA or other NSAIDs, active peptic ulcers

If no concrete proof of cyanide poisoning

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

Flammable, so remove all sources of ignition

Asthma patient

Hepatic or Renal insufficiency

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

Nausea, vomiting, constipation, cramping, bloating

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

Drowsiness

Inhalation

PO

IM, SQ, Nebulized

IM, IV

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

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

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

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

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

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

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

0.2 or 0.3 mL glass ampoule

1 mg/mL (requires reconstitution)

50 mg/ml

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

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

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