Amyl Nitrate

Question 0

Mechanism of Action

Answer 0

Short acting vasodilator and SMC relaxant that oxidizes hemoglobin to become methemoglobin, which forms a non-toxic complex with the cyanide ion to form cyanomethemoglobin, which can be enzymatically degraded

Question 1

Drug classification

Answer 1

Antidote/ Nitrate Vasodilator

Question 2

Pharmacokinetics

Answer 2

OOA- 10-30sec
Peak- 30sec
Duration- 3-5min
H/L- n/a

Question 3

Indications

Answer 3

Cyanide poisoning

Question 4

Contraindications

Answer 4

None

Question 5

Side Effects

Answer 5

HA, dizziness, weakness, flushing, cold sweats, tachycardia, syncope, orthostatic hypotension, NV

Question 6

Dose

Answer 6

Adult/Pedi- 0.3ml ampule crushed, inhaled over 15-30sec, q 1 min until sodium nitrate infusion is available

Question 7

Precautions

Answer 7

May be a medication of abuse, should be stored in secure place with narcotics
Smells like dirty, sweaty socks
Ensure patient is sitting prior to administration, hypotension and syncope may be sudden

Question 8

Drug-Drug

Answer 8

Hypotension potentiated by antihypertensives, B blockers, and certain antiemetics (phenothiazines)