Hydrocyanic Acid And Other Cyanides

Hydrocyanic acid and its salts (cyanides) are strong poisons that affect the central nervous system and tissue respiration. They have a neurotoxic effect by blocking the enzyme cytochrome oxidase in cells, which leads to tissue hypoxia.

Cyanide poisoning is characterized by rapid development of symptoms. A sharp headache, nausea, vomiting, abdominal pain, increasing weakness, severe shortness of breath, palpitations, psychomotor agitation, convulsions, and loss of consciousness appear. The skin becomes bright pink, the mucous membranes become cyanotic.

When a lethal dose (0.05 g) is ingested, clonic-tonic convulsions, severe cyanosis, acute cardiovascular failure and respiratory arrest develop. In case of poisoning with organic compounds of hydrocyanic acid, metabolic acidosis is pronounced.

Death can occur within a few minutes (fulminant form of poisoning).

Treatment includes inhalation of amyl nitrite, gastric lavage with solutions of potassium permanganate or sodium thiosulfate, and ingestion of activated carbon. Intravenous administration of sodium nitrate, sodium thiosulfate, methylene blue, glucose, and ascorbic acid is carried out. Cyanocobalamin is prescribed and hyperbaric oxygen therapy is performed. If necessary, hemodialysis, as well as therapy for cardiovascular failure.