View source for Sodium thiosulfate

==Administration==
*Type: [[Antidote]]
*Dosage Forms:
*Routes of Administration: IV
*Common Trade Names: 

==Adult Dosing==
===[[Cyanide toxicity]]===
*Adult: 12.5 g IV (after giving [[sodium nitrite]] 300 mg)

===Prophylaxis during nitroprusside infusion===
*Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside

==Pediatric Dosing==
===[[Cyanide toxicity]]===
*Pediatric: 400 mg/kg IV
*Per micromedex: 412.5 mg/kg or 7 g/m(2) administered at a rate of 0.625 to 1.25 g/min IV

===Prophylaxis during nitroprusside infusion===
*Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside

==Special Populations==
*[[Drug pregnancy categories|Pregnancy Rating]]: C
*Lactation risk: Infant risk cannot be ruled out
*Renal dosing: not established
*Hepatic dosing: not established

==Indications==
*Acute [[cyanide toxicity]]
*[[Smoke inhalation]] with potential for cyanide exposure
*Prophylaxis during [[nitroprusside]] infusions

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
===Serious===

===Common===
*Burning sensation and muscle cramping from infusion

==Pharmacology==
*Half-life: 80 min 
*Metabolism: Liver
*Excretion: Renal

==Mechanism of Action==
*Sulfur donor that promotes conversion of cyanide to thiocyanate

==Comments==
*Whereas the nitrites have adverse effects (induction of [[methemoglobinemia]]), sodium thiosulfate is non-toxic
**Should avoid nitrites in [[cyanide toxicity]] when [[CO poisoning]] is suspected to avoid lowering oxygen-carrying capacity

==See Also==
*[[Cyanide toxicity]]
*[[Sodium nitrite]]
==References==
<references/>
*Olson, K. Poisoning and Drug Overdose, 1999.

[[Category:Pharmacology]]
[[Category:Toxicology]]