The drug of choice for Poisoning due to Substance shown in the Photograph is?
A. Prussian blue.
B. Amyl nitrite.
C. Alkaline diuresis with Sodium bicarbonate.
Ans:B. Amyl nitrite
Hydrogen Sulfide Poisoning
- Hydrogen sulfide (H2S) is a colorless, flammable gas that has strong odor of rotten eggs. H2S poisoning is mainly observed in industrial settings.
- Significant hydrogen sulfide poisoning usually occurs by inhalation.
- Hydrogen sulfide forms a complex bond to the ferric moiety causing inhibition of mitochondrial cytochrome oxidase (iron-containing protein), thereby arresting aerobic metabolism similar to cyanide toxicity.
- As a cellular poison, hydrogen sulfide affects all organs, particularly the CNS and pulmonary system.
- Initial treatment of hydrogen sulfide exposure requires immediate removal of the victim from the contaminated area into a ventilated/fresh-air environment.
- High-flow (100%) oxygen is the mainstay of therapy for hydrogen sulfide poisoning.
- IV fluids and vasopressors in hypotensive patients. Correction of acidosis based on arterial blood gas and serum lactate values is indicated.
- Based on the similarities in cyanide and hydrogen sulfide toxicity, induced methemoglobinemia may be used in hydrogen sulfide toxicity.
- Nitrite administration leads to formation of methemoglobinemia.