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Cyanide prevents the use of oxygen at the cytochrome oxidase at the mitochondria in the cell. This results in very rapid change to anaerobic metabolism by the cell.
Cyanide prevents the use of oxygen at a critical site (Aa3) on the electron transport chain. The end result is excess lactate in the muscle cells. Since muscle cells cannot utilize lactate it is released into the serum where it can be metabolized in the liver back to glucose. The very high levels of serum lactate reflect the very highly toxic nature of cyanide. It is bound tightly and irreversibly to the Aa3 rapidly causing anaerobic metabolism. While other poisons may attach to Aa3 (Carbon Monoxide) they are not as tightly bound, and thus not as toxic.
A more detailed answer is as follows.
Oxygen is not allowed the attach to the Aa3 (cytochrome oxidase) site on the electron transport chain. Electrons released by the upper sites on the chain are unable to be utilized, and the chain backs up with free electrons. NADH and FADH2 cannot oxidize into NAD+ and FAD, thus the whole electron chain is inactivated. Because NAD+ and NADH become unavailable the Krebs cycle in inactivated. The glycolysis pathway continues to function, but Pyruvate acid must be changed to Lactic acid to generate enough NAD+ to keep the gylcolysis pathway functioning. The end result is only 2 ATP available instead of the normal 36. Cellular function rapidly fails and lactic acid very rapidly increases.
Very high ( greater than 10 mmol/L) levels of Lactate indicate almost a complete failure of the metabolic pathway. Cyanide is the one poison that can render this system inactive so rapidly
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What other conditions will a physician check for in a burn patient?
He or she may also check for smoke inhalation, carbon monoxide poisoning, cyanide poisoning, other event-related trauma, or, if suspected, further evidence of child abuse.
Can ringer lactate be infused in diabetic patient?
no
36) Victims caught in a fire have inhaled toxic smoke from furnishings and plastics that have released cyanide in the burning process. What precautionside effects should you be aware of when administe?
Administering medical oxygen could exacerbate the effects of cyanide poisoning, which can lead to respiratory distress. It is important to monitor the patient closely for symptoms such as altered mental status, headache, confusion, and shortness of breath. Immediate treatment with cyanide antidotes such as hydroxocobalamin or sodium thiosulfate may be necessary.
What is cyanide antidotes?
Cyanide poisoning occurs because cyanide inhibits the enzyme cytochrome c oxidase, which is one of the enzymes that enable cells to use oxygen. Antidotes for cyanide poisoning tend to focus on binding the cyanide ion so that this inhibition stops. The liver is capable of metabolizing cyanide as well, to take care of any small residual amounts remaining.There are several ways to accomplish this. Nitrites and/or 4-dimethylaminophenol both convert hemoglobin to methemoglobin, which binds tightly with cyanide. This causes problems of its own, though ... methemoglobin cannot carry oxygen, and it's necessary to convert a lot of hemoglobin to methemoglobin to be sure there's an excess to bind all the cyanide, which leaves the person treated with methemoglobinemia ... which then must be treated separately (usually by treatment with methylene blue). Thiosulfates react with cyanide to convert it to thiocyanide, which is much less toxic. However, the reaction does not occur quickly in the body, so this treatment must be supplemented with one of the others (usually nitrates/4-DMAP). Cyanide is present in one form of vitamin B12, so treatment with the cyanideless form hydroxocobalamin will bind cyanide in the harmless cyanocobalamin. Cobalt ions in general will bind cyanide, but cyanocobalt complexes are themselves generally toxic, so this is not necessarily much of an improvement. It is fast, though, and is sometimes used (in the form of the dicobalt EDTA complex) in cases of severe cyanide poisoning. Administration with glucose helps mitigate the toxic effects of the cyanocobalt complexes.
What is the prognosis for a patient with CO poisoning?
The speed and degree of recovery from CO poisoning depends on the length and duration of exposure to the gas.
How is chronic chemical poisoning treated by doctors?
Treatment of chronic chemical poisoning involves identifying, eliminating the source of poison from the patient's environment, and symptomatic treatment of the condition.
How To prevent a patient from dehydrating?
give them wateranswerif no vomitingORS(oral rehydration solution) is the bestif their is vomiting than simply put the patient on intravenous fluide like normal saline,ringer lactate and treat the underlaying cause
How can you get rid of food poisoning?
Most often, the symptoms of food poisoning will resolve on their own, with hydration and rest being the mainstays of treatment. Occasionally, poisoning caused by germs like bacteria can cause more serious infections with complications that require evaluation by a doctor antibiotic treatment.
How is hypotension associated with receiving epidural anesthesia obviated?
the infusion of 500-1000 cc of fluid intravenously into the patient prior to the procedure. Ringer's lactate is preferable to a solution containing dextrose
How are most cases of plant poisoning treated?
Most cases of plant poisoning are treated by inducing vomiting, if the patient is fully conscious. Vomiting can be induced by taking syrup of ipecac, an over-the-counter emetic available at any pharmacy.
How are most cases of mushroom poisoning diagnosed?
In most cases, the fact that the patient has recently eaten wild mushrooms is the clue to the cause of symptoms.
What techniques are available to treat radiation poisoning?
About the only thing that can be done in cases of radiation poisoning is to treat symptoms as they appear and wait. Depending on the dosage the patient will either recover or die. Proper treatment of symptoms increases the chance of recovery at lower dosages, but at high dosages do nothing but temporarily reduce pain and suffering prior to the patient's unavoidable death.
