Pathophysiology of cyanide poisioning

[Kenny0471]

Hi Everyone,

I have been working on the pathophysiology of Cyanide poisoning I believe that I have captured this correctly, but would love a second a opinion..

Pathophysiology: Cyanide exposure can be a result of inhalation, ingestion or absorption. Once this has entered the body it is rapidly spread to the organs of the body. Inside the cells of the body the cyanide binds to ubiquitous metalloenzymes, rendering them inactive for use. The primary reason toxicity causes by cyanide poisoning is a result of the inactivation of cytochrome oxidase at cytochrome A3.

 

Intracellular, cyanide attaches itself to ubiquitous metalloenzymes, rendering them inactive. The toxicity results from inactivation of cytochrome oxidase and further uncouples mitochondrial oxidative phosphorylation and inhibiting cellular respiration even in the presence of excessive oxygen saturation during treatment. Because of this cellular respiration shifts from aerobic to anaerobic, causing a rise is lactic acid. Because of this process the brain and heart which are at the highest risk due to the additional oxygenation required for normal homeostatic purposes.

 

One type of treatment (Antidote) of cyanide positioning can be to convert (oxidize) ferrous ions in hemoglobin to ferric ions. This forms methemoglobin, which is hemoglobin with ferrous ion in the oxidized state. Cyanide which has a greater attraction to these ferric states of the cells. Because of this the cyanide is released from the cytochrome oxidase and combines with the newly created methemoglobin.  This process allows cytochrome oxidase to results its function in cellular respiration.

 

Methemoglobin cannot transport oxygen, so without counter measures this will result in further tissue damage and necrosis. So this all forms part of a 3 phase treatment plan that is aimed at restoring the hemoglobin to its original state. Through the administration of amyl nitrate, sodium nitrate the conversion of ferrous hemoglobin to methemoglobin to capture the cyanide molecules, Further to this administration of hydroxocobalamin with or without sodium thiosulfate allows the detoxification to be completed and cellular respiration recommence.

 

Please feel free to provide constructive feedback  

[Just Plain Ruff]

So Brother, what got you to work on this?  Personal enrichment or a requirement for a course?  

The best cyanide video I ever remember was a world war 2 video where the platoon used cyanide to kill a enemy regiment while they were sleeping.  I cannot remember what movie it was from but the enemy regiment was a african regiment.  

Maybe the Wild Geese or something like that.  

[Off Label]

10 hours ago, Kenny0471 said:

 

Pathophysiology: Cyanide exposure can be a result of inhalation, ingestion or absorption. Once this has entered the body it is rapidly spread to the organs of the body. Inside the cells of the body the cyanide binds to ubiquitous metalloenzymes, rendering them inactive for use. The primary reason toxicity causes by cyanide poisoning is a result of the inactivation of cytochrome oxidase at cytochrome A3.

 

Intracellular, cyanide attaches itself to ubiquitous metalloenzymes, rendering them inactive. The toxicity results from inactivation of cytochrome oxidase and further uncouples mitochondrial oxidative phosphorylation and inhibiting cellular respiration even in the presence of excessive oxygen saturation during treatment.

 

 

Do you know what all of this means?

[Kenny0471]

10 hours ago, Just Plain Ruff said:

So Brother, what got you to work on this?  Personal enrichment or a requirement for a course?  

The best cyanide video I ever remember was a world war 2 video where the platoon used cyanide to kill a enemy regiment while they were sleeping.  I cannot remember what movie it was from but the enemy regiment was a african regiment.  

Maybe the Wild Geese or something like that.  

Hi,

I am currently studying paramedics within Australia.

Could you find me the video? That would be appreciated, although I have actually watched a few videos regarding this.

Thanks!

4 hours ago, Off Label said:

Do you know what all of this means?

Hi Off Label,

In a perfect world I would say that I understand 85% of this, yes.

I found the major cause of cyanide poisoning is the ability for the cellular damaged causes by the attachment to hemoglobin.

Do you care to elaborate on this? I am very much happy for any kind of constructive feedback

[Just Plain Ruff]

have been unable to find the video.  It's not really a valid video for this as the second that the soldiers were sprayed with the cyanide gas they died.  I think it takes a bit longer for someone to die with Cyanide.  

I just remember the movie because it was so violent and at the time I was in junior high (1980)  I was sheltered at that age.  ha ha 

[chbare]

On 7/7/2017 at 6:29 PM, Kenny0471 said:

Hi,

I am currently studying paramedics within Australia.

Could you find me the video? That would be appreciated, although I have actually watched a few videos regarding this.

Thanks!

Hi Off Label,

In a perfect world I would say that I understand 85% of this, yes.

I found the major cause of cyanide poisoning is the ability for the cellular damaged causes by the attachment to hemoglobin.

Do you care to elaborate on this? I am very much happy for any kind of constructive feedback

Good day. You are a bit off but the general reasoning in the the right direction. I will post a video that I filmed some years ago while I was in graduate school. It covers this topic, but I'd ask that you review the concepts of ferrous versus ferric Iron and ultimately, the concept of oxidation state. The Iron in Cytochrome c oxidase is in a similar configuration as haemoglobin but the enzyme dynamics dictate a narrative that is counter to the typical "blood poisoning" that sometimes surrounds a discussion of Cyanide Toxicity. 

I must warn you that I was grossly overweight and profoundly depressed when I made the video, so it's not super high fidelity, but the information is relevant nonetheless. 

 

[Kenny0471]

2 hours ago, chbare said:

Good day. You are a bit off but the general reasoning in the the right direction. I will post a video that I filmed some years ago while I was in graduate school. It covers this topic, but I'd ask that you review the concepts of ferrous versus ferric Iron and ultimately, the concept of oxidation state. The Iron in Cytochrome c oxidase is in a similar configuration as haemoglobin but the enzyme dynamics dictate a narrative that is counter to the typical "blood poisoning" that sometimes surrounds a discussion of Cyanide Toxicity. 

I must warn you that I was grossly overweight and profoundly depressed when I made the video, so it's not super high fidelity, but the information is relevant nonetheless. 

 

Hi There,

 

I don't judge people, no need to clarify. I appreciate any and all feedback required.

 

Thank you very much for your time mate.

[Just Plain Ruff]

Chris,  if you were overweight in that video, you just have to see me!!!!  ha ha

Your videos are so informative and good to watch.  

[Off Label]

Kenny,

I just ask because I don't understand what cytochrome oxidase at cytochrome A3 is let alone cytochrome A3. I was asking because I was curious as to the back round you were bringing to your training.

Good news for me is that I don't need to know that stuff to treat cyanide poisoning!

[Kenny0471]

11 minutes ago, Off Label said:

Kenny,

I just ask because I don't understand what cytochrome oxidase at cytochrome A3 is let alone cytochrome A3. I was asking because I was curious as to the back round you were bringing to your training.

Good news for me is that I don't need to know that stuff to treat cyanide poisoning!

Ha You are right, why do we need to know what cytochrome oxidase is, at a cellular level. We are there to treat it. But that is the question they wish to have an answer for.  But to answer your question, Cytochrome oxidase is just part of the cellular reaction that cyanide has, the most important thing that we need to know at an EMT or above level is the shift in the oxyhaemoglobin dissociation curve and how our treatment can rectify this injury.

 

The enzyme cytochrome c oxidase or Complex IV is a large transmembrane protein complex found in bacteria and the mitochondrion of eukaryotes. I believe that your cyanide poison kits that are present in some states in the Americas actually acts on this enzyme to promote a positive shift in the curve, however I have no researched this a lot.

 

But hey I am just a training, I like this forum so far, very helpful people. I am sure I will have other questions. Thanks again all.