HYDROXOCOBALAMIN

Question 1

HYDROXOCOBALAMIN

CLASS/ACTIONS:

Answer 1

CLASS: Cyanide Antidote

ACTIONS:

• Directly binds to cyanide to form the nontoxic compound cyanocobalamin, which is then excreted in the urine

Question 2

HYDROXOCOBALAMIN

INDICATIONS:

Answer 2

INDICATIONS:

• Symptomatic cyanide exposure, known or suspected.

Question 3

HYDROXOCOBALAMIN

CONTRAINDICATIONS:

Answer 3

CONTRAINDICATIONS:

• None.

Question 4

HYDROXOCOBALAMIN

PRECAUTIONS:

Answer 4

PRECAUTIONS:

 The most common adverse reactions are development of reddish skin, mucous membranes, and urine up to three days after infusion.

Question 5

HYDROXOCOBALAMIN

PREPARATION:

Answer 5

PREPARATION:

• Using double-side spike and 5 G vial included in CYANOKIT box, fill the vial to the fill-line (200ml) with a bag of normal saline (dextrose may be used). The resulting concentration will be 25mg/ml.

Question 6

HYDROXOCOBALAMIN

ADULT DOSE/ROUTE:

Answer 6

ADULT DOSE/ROUTE:

• 5 grams IV infused over 15 minutes

Question 7

HYDROXOCOBALAMIN

PEDIATRIC DOSE/ROUTE:

Answer 7

PEDIATRIC DOSE/ROUTE:

• 70 mg/kg IV infused over 15 minutes

Question 8

HYDROXOCOBALAMIN

NOTES:

Answer 8

NOTES

• Hydroxocobalamin has replaced Sodium Thiosulfate.
• Hydroxocobalamin has limited toxicity and may be used when cyanide exposure is suspected, but not confirmed.
• Hydroxocobalamin is not routinely stocked on the ambulances, but is available in the pharmaceutical disaster and hazmat caches.