Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 9 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Cyanide: Mechanism of Action • Readily enters cells • Inhibits mitochondrial respiration Module Four – Cyanide & Fumigants 9 Cyanide is a systemic poison with no single target organ. Cyanide acts by inhibiting enzymes within the mitochondria (or powerhouse) of all cells. This results in the complete arrest of cellular respiration and chemical asphyxiation of affected cells. In simple terms, the cells suffocate. The heart and CNS system, being the most oxygensensitive organs in the human body, are most affected by cyanide poisoning. Cyanide is an inhibitor of the enzyme cytochrome c oxidase (also known as aa3) in the fourth complex of the electron transport chain (found in the membrane of the mitochondria of eukaryotic cells.) It attaches to the iron within this protein and prevents oxygen from acting as the final electron acceptor in the chain. Thus the cell can no longer aerobically produce ATP for energy. Tissues that mainly depend on aerobic respiration, such as the central nervous system and the heart, are particularly affected. December 2008 Version 2.0 Page 196
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 10 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Cyanide Other Cytochrome Oxidase Inhibitors: • Hydrogen sulfide – “sewer gas” • Sodium azide – Component of airbags • Carbon monoxide – minor mechanism Module Four – Cyanide & Fumigants 10 There are other cytochrome oxidase inhibitors, such as hydrogen sulfide, sodium azide, and carbon monoxide. Exposure to these other cytochrome oxidase inhibitors, due to their similar mechanism of action, may produce systemic clinical effects similar to cyanide poisoning. Hydrogen sulfide, also called sewer gas, is found in manure pits, but also has use in industry. Sodium azide is a colorless azide salt commonly used in organic synthesis, and it is a component in many car airbag systems. Carbon monoxide is readily generated by burning organic matter. When a victim presents with rapid loss of consiousness that is considered to be related to an inhalational exposure, the likely of a “knock down gas” is raised. The differential diagnosis boils down to the following “knock down gases”: cyanide gas, hydrogen sulfide gas, carbon monoxide, and oxygendeficient air. Hydrogen sulfide, H2S, is colorless, toxic and flammable gas is partially responsible for the foul odor of rotten eggs. It is irritating and has good warning properties due to its sulfury odor; however at high concentrations this chemical’s odor paradoxically fades and poisoning is likely. Azide is the anion with the formula N 3 - ; Sodium azide is the sodium salt NaN 3 This latter compound is colorless and is a common reagent in organic synthesis, and is a component in many car airbag deployment systems because of its explosive nature (it forces out the airbag). Carbon monoxide, or CO, is a colorless, odorless gas that is produced during incomplete combustion of organic compounds. It inhibits mitochondria similarly to the way that CN does, but it has other more consequential toxic effects on the red blood cells. Poisoning by each is preventable with proper safety systems or personal protective equipment. December 2008 Version 2.0 Page 197
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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