Fatal Cases of Poisoning with Sodium Nitroprusside

Lazarus-Barlow, P.; Norman, G. M.

doi:10.1136/bmj.2.4211.407

Cited by 9 publications

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“…Hydrogen cyanide (HCN) has been detected in animal and human tissues following poisoning with sodium nitroprusside (SNP) (Hermann, 1886;Johnson, 1929;Annotation, 1936Annotation, , 1948Lazarus-Barlow and Norman, 1941). Hill (1942) also found HCN in a fatal case of SNP poisoning and was able to demonstrate cyanide formation in whole blood or tissue incubated with nitroprusside.…”

mentioning

confidence: 99%

Cyanide and Thiocyanate Concentrations Following Sodium Nitroprusside Infusion in Man

Vesey¹,

Cole²,

Simpson³

1976

British Journal of Anaesthesia

176

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Twenty-six patients, receiving an infusion of sodium nitroprusside (SNP) during surgery, had considerable increases in both red cell and plasma cyanide concentration, but only small changes in plasma thiocyanate concentration. There was a linear relationship between both plasma and RBC cyanide concentrations and the total dose of SNP. The expired cyanide concentration followed the changes in the plasma. We believe that the development of metabolic acidosis, and the recent fatalities involving SNP, are attributable to histotoxic hypoxia as a result of excessive plasma concentrations of cyanide. On the basis of our results, we recommend that the total dose of SNP should not exceed 1.5 mg/kg during short-term infusions and that the plasma cyanide should not exceed 300 nmol%. Plasma thiocyanate concentrations are, in general, an unreliable indication of extent of exposure to cyanide, although they may become important during long-term infusions.

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confidence: 99%

Cyanide and Thiocyanate Concentrations Following Sodium Nitroprusside Infusion in Man

Vesey¹,

Cole²,

Simpson³

1976

British Journal of Anaesthesia

176

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“…Hydrogen cyanide has also been detected in cases of nitroprusside poiming (Pharmaceutical Yourmal, 1936, 1948Lazarus-Barlow and Norman, 1941;Hill, 1942). Our study, using more senitive techniques for cyanide determnination than hitherto employed, showed ,thait cyanide was liberated in vivo from therapeutic doses, of nitroprusside.…”

Section: Discussionmentioning

confidence: 99%

Some Metabolic Effects of Sodium Nitroprusside in Man

Vesey¹,

Cole²,

Linnell³

et al. 1974

BMJ

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SummaryThe infusion of sodium nitroprusside during surgical operations produced plasma levels of cyanide of up to four times the control value. Plasma thiocyanate showed little change except during prolonged infusion of the drug, but total plasma B12 tended to fall, as did methylcobalamin. Other cobalamins showed little change after nitroprusside infusion for short periods. During longer infusions the ratio of methylcobalamin to adenosyl + hydroxocobalamin fell and cyanocobalamin concentrations were high.

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“…However, sodium nitroprusside still remains a toxic product, and cases of voluntary or accidental poisoning are found in publications (11,15). All clinicians know of the redoubtable variability in the responses, according to the patient, to the same dose of sodium nitroprusside.…”

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Variation of the Sensibility of Different Animal Species Subjected to Sodium Nitroprusside

Pham-Huu-Chanh¹,

Silve-Mamy²,

Luong-Thi-Ngoc-Suong³

et al. 1966

Pharmacology

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Fatal Cases of Poisoning with Sodium Nitroprusside

Abstract: The followincases are worthy of record in view of the chemical compound which was the cause of death. CASE I The patient, a second-year probationer nurse aged 23, had had vague abdominal pain suggestive of chronic appendicitis in July,

Cited by 9 publications

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Cyanide and Thiocyanate Concentrations Following Sodium Nitroprusside Infusion in Man

Cyanide and Thiocyanate Concentrations Following Sodium Nitroprusside Infusion in Man

Some Metabolic Effects of Sodium Nitroprusside in Man

Variation of the Sensibility of Different Animal Species Subjected to Sodium Nitroprusside

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