The antidotal action of thiosulfate following acute nitroprusside infusion in dogs

Anesthesiology. 1985 Apr;62(4):415-21. doi: 10.1097/00000542-198504000-00008.

Abstract

The authors previously demonstrated in dogs that a bolus dose of sodium thiosulfate maintained enhanced cyanide metabolism throughout a 1-h infusion of sodium nitroprusside (SNP). To further test this antidotal action, a bolus dose of thiosulfate (150 mg . kg-1) was given to eight dogs at the end of a 60-min near-lethal infusion of nitroprusside (3 mg . kg-1). Within 2 min of the antidote, mean plasma thiocyanate levels (70.3 mumol . l-1) were significantly higher than those of seven control dogs given nitroprusside only (45.9 mumol . l-1, P = 0.002) and plateaued at 153.8 mumol . l-1 within 60 min, while the control values only reached 79.1 mumol . l-1 (P less than 0.001). Although differences between plasma cyanide levels in the two groups only attained significance 1 h after administering the antidote (0.8 vs. 2.74 mumol . l-1, P = 0.03), red blood cell cyanide concentrations were significantly lower in the antidote group within 5 min (166 vs. 225 mumol . l-1, P = 0.004) and remained so throughout the 2-h observation period. Compared with the controls, there was an impressive reduction in mean half-lives of plasma cyanide (25.1 vs. 74.1 min) and red blood cell cyanide (22.4 vs. 203.6 min). Similarly, peak cyanide levels occurred much sooner following the antidote (mean times: plasma cyanide 2.9 vs. 5.9 min; red blood cell cyanide 0.25 vs. 11 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acid-Base Imbalance / blood
  • Acid-Base Imbalance / chemically induced
  • Acid-Base Imbalance / prevention & control
  • Animals
  • Antidotes*
  • Dogs
  • Erythrocytes / metabolism
  • Ferricyanides / administration & dosage*
  • Hydrogen Cyanide / blood
  • Hydrogen Cyanide / poisoning*
  • Infusions, Parenteral
  • Injections, Intravenous
  • Lactates / blood
  • Lactic Acid
  • Nitroprusside / administration & dosage*
  • Thiocyanates / blood
  • Thiosulfates / administration & dosage
  • Thiosulfates / therapeutic use*

Substances

  • Antidotes
  • Ferricyanides
  • Lactates
  • Thiocyanates
  • Thiosulfates
  • Nitroprusside
  • Hydrogen Cyanide
  • Lactic Acid
  • sodium thiosulfate