Dyshemoglobinemias

Question 1

Class;Mechanism;Therapeutics;SideEffects

Hyperbaric oxygen

Answer 1

— — Prevents lipid peroxidation (?) and delayed neurologic sequelae in CO poisoning — — —

Question 2

Class;Mechanism;Therapeutics;SideEffects

Nitrites

Answer 2

— Turns RBC hemoglobin to methemoglobin; CN moves from Fe(3+) on cytochromes to those in RBCs creating cyanomethemoglobin — — — Dangerous in concurrent CO poisoning

Question 3

Class;Mechanism;Therapeutics;SideEffects

Sodium thiosulfate

Answer 3

— Enhances normal metabolism of cyanide via rhodanase — — — —

Question 4

Class;Mechanism;Therapeutics;SideEffects

Hydroxycobalamin (Cyanokit)

Answer 4

— Binds with cyanide –> cyanocobalamin (B12) Smoke inhalation victims not improving with supportive care, cyanide exposure, nitroprusside at risk patients — — Give concurrently with sodium thiosulfate

Question 5

Class;Mechanism;Therapeutics;SideEffects

Methylene blue (Urolene Blue)

Answer 5

— Cofactor of NADPH reductase; gains electron, donates directly to reduce methemoglobin Methemoglobinemia >20-30%, or with symptoms Hemolytic anemia (weak oxidizing capability) Painful at injection site, dyspnea, restlessness, tremor, precordial pain, and apprehension —