Simple and Chemical Asphyxiants, Neurotoxins, and Cardiotoxins

Question 1

methemoglobinemia

Answer 1

reversible with methylene blue antidote

Question 2

sulfhemoglobinemia

Answer 2

irreversible with no antidote and supportive care is key

Question 3

how to renally eliminate sulf Hg?

Answer 3

use sodium nitrate to make MetHg and in presence of Sulf Hg becomes sulfMetHg to get renally eliminated

Question 4

How to treat sulhemoglobinemia?

Answer 4

supportive care
early diagnosis and intervention to prevent end organ damage
RBC and plasma transfusion

Question 5

cyanokit for CN poisoning

Answer 5

trades one poison for another (MetHg for CNHg)
made of amyl nitrite, sodium nitrite, sodium thiosulfate
makes methoglobin to cyanide to thiocyanate which is excreted renally

Question 6

CN mechanism

Answer 6

CN inactivates mitochondrial oxidative phosphorylation

Question 7

CN treatment

Answer 7

hydroxycobalimin (vitamin B12) turns cyanide to cyanocobalamin to be eliminated in urine
or amyl nitrite + sodium nitrite to make methoglobinemia bind to CN
Sodium thiosulfate converts CN to thiocyanate to be renally excreted

Question 8

CN and H2S bind to ?

Answer 8

cytochrome c oxidase to impair oxidative metabolism

Question 9

sulfhemoglobin is not?

Answer 9

effective in transporting oxygen

Question 10

shifts O2 dissociation curve to the right

Answer 10

(in favor of oxygen unbinding) sulfhemoglobin