Question
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.
D. Dimercaprol.
Show Answer
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Correct Answer » B
Explanation
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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.
Treatment:
- 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.
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