Nitroprusside and Cyanide Toxicity – Part 4
Treatment of cyanide toxicity begins with discontinuation of sodium nitroprusside administration. Patients should be concomitantly placed on supplemental oxygen and may even require mechanical ventilation. Additionally, thiosulfate and sodium nitrate (to convert hemoglobin to methemoglobin) can be given to increase the kinetics of the other metabolic pathways, resulting in less cyanide being available to bind to cytochrome oxidase. Additionally, thiosulfate can be given concomitantly with with nitroprusside to lessen the risks of cyanide toxicity from developing.
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