Amyl nitrite
Administration
- Type: Antidote, anti-anginal agent
- Dosage Forms: crushable ampules; liquid for inhalation
- Dosage Strengths: 0.3 mL
- Routes of Administration: inhalation
- Common Trade Names: Component of Cyanide Antidote Package (Lilly kit)
Adult Dosing
- Cyanide toxicity: Crush one to two ampules in gauze, cloth, or a sponge and place under patient's nose, in O2 face mask, or port access of ETT. Patient should inhale deeply for 30s, rest for 30s, and repeat for 2-3 minutes
Pediatric Dosing
- As above
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
Contraindications
- Allergy to class/drug
- Cerebral hemorrhage, recent severe head trauma
Adverse Reactions
Serious
- Methemoglobinemia (this is the point when used for cyanide toxicity)
- Raised ICP
- Rased IOP
- Syncope
Common
- Orthostatic hypotension, dizziness
- Headache
- Flushing
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of Action
- Convert the iron in hemoglobin from the ferrous to the ferric form, creating methemoglobinemia. Then, the thiosulfate can become sulfate donor, allowing conversion of cyanide to readily renally excretable form