Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 35 Chemical Agents of Opportunity for Terrorism: TICs & TIMs • Effective • Safe • Side Effects – Nitrite • Hypotension • MetHb – Sodium Thiosulfate • vomiting Cyanide: CAK Module Four – Cyanide & Fumigants 35 While generally safe and effective several undesirable adverse effects are associated with CAK therapy. The administration of nitrite may induce hypotension and methemoglobinemia, while sodium thiosulfate may induce vomiting. . December 2008 Version 2.0 Page 222
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 36 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Cyanokit • Hydroxocobalamin • Converts cyanide to cyanocobalamin (vitamin B12) Cyanide: Cyanokit Dosing • 5g IV • 10g IV in cardiac arrest Module Four – Cyanide & Fumigants 36 The newer antidote is the one-step “Cyanokit®” which contains hydroxocobalamin. This antidote has been in use in Europe for decades and was introduced in the US in 2006. Hydroxocobalamin is administered intravenously and binds with cyanide to form cyanocobalamin (i.e. vitamin B12) which is renally excretable. The dose is 5 grams intravenously if the patient is symptomatic and 10 grams if the patient is suffering from cardiac arrest. December 2008 Version 2.0 Page 223
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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