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Last update 23 Jan 2025

Cyanide poisoning

Last update 23 Jan 2025

Basic Info

Synonyms

CYANIDE POISONING, Cyanide poisoning, Cyanide poisoning syndrome

+ [12]

Introduction

A rare intoxication characterized by onset of toxic manifestations within seconds to hours - depending on the route, duration, dosage, and source of exposure - after inhalation of volatile cyanides (especially from fire smoke), ingestion of cyanide (including use of certain medications) or contact with the skin or mucous membranes. In severe cases following inhalation, signs of hyperventilation appear within seconds or minutes and are followed by loss of consciousness with convulsions and ultimately cardiovascular collapse and/or respiratory arrest. Other clinical signs include dizziness, weakness, palpitations, and anxiety, followed by dyspnea, pulmonary edema, confusion, ataxia, and paralysis.

Drugs associated with Cyanide poisoning

Sodium Thiosulfate

Target-

Mechanism

Sulfur atom donors

Active Org.

Pfizer Australia Pty Ltd. [+8]

Originator Org.

Nichi-Iko Pharmaceutical Co., Ltd.

Active Indication

Ototoxicity [+5]

Inactive Indication

Calciphylaxis

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

First Approval Date11 May 1984

Hydroxocobalamin

Target

IFNAR

Mechanism

IFNAR agonists

Active Org.

SERB SA [+7]

Originator Org.

Merck & Co., Inc.

Active Indication

Cyanide poisoning [+8]

Inactive Indication-

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

First Approval Date18 Apr 1975

4-(Dimethylamino)phenol hydrochloride

Target-

Mechanism-

Active Org.

Academy of Military Med Sci, Inst of Toxicology & Pharmacology

Originator Org.-

Active Indication

Cyanide poisoning

Inactive Indication-

Drug Highest PhasePhase 1

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

Clinical Trials associated with Cyanide poisoning

NCT05194358

/ CompletedPhase 1

Phase 1, Open Label, Single Ascending Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Stabilized Isoamyl Nitrite (SIAN) Nasal Spray in Healthy Adults

This study is designed to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of single ascending doses of Stabilized Isoamyl Nitrite (SIAN) nasal spray in healthy subjects.

Start Date21 Dec 2021

Sponsor / Collaborator

Emergent BioSolutions, Inc.

[+1]

CTRI/2013/02/003355

/ RecruitingPhase 2

An open labeled, comparative, step-up phase-2 clinical study to assess bioavailability and efficacy of sodium alpha-ketoglutarate infusion injection in patients with cyanide overload

Start Date31 Aug 2012

Sponsor / Collaborator

Defence Research & Development Establishment

CTRI/2013/01/003331

/ RecruitingPhase 2

A phase-II open labeled, comparative, field study to assess efficacy of oral sodium alpha-ketoglutarate in treating cyanide poisoning

Start Date31 Aug 2012

Sponsor / Collaborator

Defence Research & Development Establishment

100 Clinical Results associated with Cyanide poisoning

100 Translational Medicine associated with Cyanide poisoning

0 Patents (Medical) associated with Cyanide poisoning

1,202

Literatures (Medical) associated with Cyanide poisoning

01 Feb 2025·Forensic Science International

Forensic metabolomics: Tracing cyanide-induced metabolic changes in fatalities

Article

Author: Pardo-Rodriguez, Daniel ; Guerrero Alvarez, Gloria E ; Ariza-Garcia, Wilmar Alexander ; Cala, Mónica P ; Rosero-Moreano, Milton ; Taborda-Ocampo, Gonzalo

Accurate detection of cyanide exposure is crucial, particularly in forensic science. However, cyanide's high volatility and potential biochemical conversions in biological samples pose challenges for direct detection, complicating the determination of cause of death. Identifying alternative cyanide metabolites as markers may mitigate false negatives and positives, extending the detection window in poisoning cases. This study aimed to evaluate metabolic changes induced by cyanide exposure in forensic cases using a multi-platform approach, including metabolomics and lipidomics analyses via liquid and gas chromatography coupled with high-resolution mass spectrometry. Results demonstrated clear discrimination between cyanide-exposed and control groups through OPLS-DA models. A total of 92 altered metabolites were identified in cyanide-exposed individuals compared to controls. Significant changes in metabolites primarily included glycerophospholipids (30.7 %), glycerolipids (14 %), fatty acyls (12.9 %), sphingolipids (8.0 %), amino acids and analogs (8.0 %), among others. Cyanide intoxication disrupted multiple metabolic pathways, including mitochondrial β-oxidation, acylcarnitine accumulation, a shift towards gluconeogenesis in amino acid metabolism, and ammonia homeostasis disturbance, affecting both ammonia recycling and the urea cycle. These pathways are essential for cellular energy production. The altered metabolic profiles provide insight into cyanide poisoning pathways, potentially aiding the development of new forensic diagnostic strategies. The area under the receiver operating characteristic curve was used to assess each model's predictive value. Findings suggest that metabolites such as phosphate and 3-hydroxybutyric acid could serve as diagnostic biomarkers in lethal cyanide poisoning cases. Future studies must evaluate these potential biomarkers' effectiveness in different fatal victim cohorts and validate the suggested panel through a targeted approach.

01 Feb 2025·Archivos Argentinos de Pediatria

Acute cyanide intoxication due to apricot seed ingestion

Article

Author: Güngör, Emre ; Orhan, Özhan ; Talay, Mehmet N

Introduction: Cyanide poisoning, whether it be accidental or intentional, remains a significant danger to adults and children, especially in societies where agriculture is a primary source of income. We examined the clinical follow-up, complications, and results of cyanide poisoning cases that occurred after eating the pits and seeds of plants containing cyanide glycosides, such as apricot kernels and almonds. Methods: Between 01/01/2017 and 01/08/2022, 14 children aged 1-18 years who were followed up with a prediagnosis of cyanide poisoning in our Paediatric Intensive Care Unit (PICU) were retrospectively analysed. Results: Eight of the patients followed with a preliminary diagnosis of cyanide poisoning were female and six were male. The most common admission month was July (42.8%) coinciding with the agricultural season. The most common symptoms at presentation were weakness and fatigue (n = 7). In the PICU, 4 patients presented lip cyanosis; 3, altered level of consciousness. Vomiting, seizure, headache, dizziness and palpitatons were less frequent. Four patients were treated with hydroxocobalamin (Cyanokit®) as an antidote due to acidosis in their blood gases. All patients treated for cyanide poisoning were discharged. Conclusions: Cyanide poisoning should be considered in paediatric patients with suspicious findings, sudden loss of consciousness, increased anion gap acidosis and lactic acidosis. The history of eating the seeds of plants such as apricot and almonds should be investigated.

01 Jan 2025·Journal of Forensic Sciences

A fatal case of potassium gold cyanide poisoning

Article

Author: Jung, Jieun ; Kim, Hyung Joo ; Kim, Hyejung ; Seol, Ilung ; Lee, Seungho ; Lee, Jaesin ; Ahn, Su‐Jin

AbstractA 77‐year‐old professional gold craftsman ingested a white powder used in goldsmithing, mistaking the powder for a health supplement. He detected a strange taste and immediately fell sick, reported the incident to 911, and was taken to the emergency room. He died approximately 8.5 h post‐ingestion despite treatment. There were no significant findings in the autopsy, the victim's heart blood sample, gastric contents, and the white powder the victim had taken were submitted to the department of forensic toxicology. Using scanning electron microscopy energy dispersive X‐ray analysis, potassium and gold (Au) were detected in the white powder. Ion chromatography analysis detected cyanide. Concentrations of cyanide were 0.5 mg/L in heart blood and 13.3 mg/L in gastric contents. Qualitative and quantitative analyses of Au in the heart blood sample and gastric contents using inductively coupled plasma‐optical emission spectrometry detected concentrations of 79.8 mg/L and 2010.1 mg/L, respectively. Au and cyanide synergistically enhance cytotoxicity through inhibition of detoxification and increasing intracellular accumulation. In the present case, the detected blood cyanide concentration was sub or minimally lethal, and the blood Au concentration was high. The cause of the victim's death was the combined toxicity of Au and cyanide.

News (Medical) associated with Cyanide poisoning

07 Nov 2024

·www.prnewswire.com

The Inner Circle acknowledges, Alan H. Hall, MD as a Pinnacle Lifetime Member

WEATHERFORD, Texas, Nov. 7, 2024 /PRNewswire/ -- Prominently featured in The Inner Circle, Alan H. Hall, MD is acknowledged as a Pinnacle Lifetime Member for his contributions as a Leading Expert in Medical Toxicology and Chemical Exposure. Dr. Alan H. Hall, MD, a distinguished medical toxicologist, offers unparalleled expertise in chemical exposure, toxic gases, terrorism preparedness, and decontamination procedures. Renowned as a leading authority on cyanide poisoning and its antidotal treatment, Dr. Hall is dedicated to advancing safety and preparedness on both national and global scales. Continue Reading Alan H. Hall, MD Dr. Hall's career encompasses a broad range of specialties, including medical toxicology, chemical exposure, toxic gases, and terrorism preparedness. His extensive experience also covers the decontamination of chemical splashes and advanced treatment for cyanide poisoning. Dr. Hall earned his Bachelor of Arts in Sociology from Indiana University at South Bend and his MD from Indiana University, School of Medicine in Indianapolis. He completed his family practice internship at Thomason General Hospital in El Paso, Texas, followed by a residency in anesthesiology at the University of Texas at San Antonio. His fellowship in clinical toxicology was completed at Denver General Hospital/University of Colorado Health Sciences Center in Denver. He is board certified in medical toxicology and holds an Advanced Hazmat Life Support (AHLS) Verification as a provider and instructor. Dr. Hall is a prominent member of the Society of Toxicology and the American Chemical Society Division of Chemical Health and Safety. He also actively contributes to his local American Legion Post. Dr. Hall's career is highlighted by his service in the U.S. Army, where he achieved the rank of Specialist 4, and his role as a flight surgeon with the U.S. Air Force Reserves. He has consulted with NASA on space shuttle issues and has held academic positions as a Clinical Assistant Professor at the Colorado School of Public Health and the University of Colorado School of Medicine. His previous roles also include Assistant Professor of Pediatrics at the University of Colorado School of Medicine and Research Assistant Professor at Texas Tech University Health Sciences Center El Paso. Honored with the Division of Arts and Sciences and University-wide Distinguished Alumnus awards from Indiana University South Bend, Dr. Hall is widely recognized for his contributions to the field of medical toxicology. His mentors, including Barry Rumack, MD, have greatly influenced his approach to toxicology and patient safety. Looking forward, Dr. Hall remains committed to providing expert consulting services and advancing the field of medical toxicology through international engagement and education. Contact: Katherine Green, 516-825-5634, [email protected] SOURCE The Inner Circle WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

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