Cyanides.

Guam Memorial Hospital, Department of Emergency Medicine, 850 Gov. Carlos Camacho Road, Oka, Tamuning, Guam.

Cyanide is a likely weapon for terrorists due to its notoriety, lethality, and availability. Poisoning results in central nervous system and cardiovascular dysfunction due to inhibition of oxidative phosphorylation. Laboratory findings of anion gap metabolic acidosis and hyperlactemia aid in confirming the diagnosis. Treatment for significant poisonings includes aggressive supportive care and administration of antidotes such as sodium nitrite, sodium thiosulfate, and hydroxocobalamin. Survivors of significant poisonings can have long-term neurologic dysfunction.

PMID: 16168309 [PubMed - indexed for MEDLINE]