![]() In this article we review the available data on the sources, manifestations, and treatment of acute cyanide poisoning in children and discuss unmet needs in the management of pediatric cyanide poisoning. ![]() The vitamin B 12 precursor hydroxocobalamin, which has been used in Europe, may prove to be an attractive alternative to the cyanide antidote kit for pediatric patients. ![]() in GLP regulations are found in the Code of Federal Regulations (CFR). Antidote kit should only be administered as per pre-incident training. A cyanide antidote with a better risk/benefit ratio than the current agent available in the United States is desirable. For years, Cyanide Antidote Kit (CAK Lilly) has been an available antidote. ions, which may convert to hydrogen cyanide gas (HCN) depending on the pH (see. Because hemoglobin kinetics vary with age, methemoglobinemia associated with nitrite-based antidotes may be excessive at standard adult dosing in children. Synonyms and Chemical Abstract System (CAS) numbers have been added for. Cyanide antidote kits (such as Eli Lilly Co. 85 This amount is below levels expected to affect significant exposure to carbon monoxide alone. inventory, the regulations of 40 CFR 355 and 370 apply, including submission of Tier I / Tier II. It has been shown that the mean peak amount of methemoglobin levels achieved after the administration of 300 mg of sodium nitrite is 10.5. This designation includes any isomers and hydrates, as well as any solutions and mixtures containing these substances. The cyanide antidote kit may be unsuitable for use in patients with carboxyhemoglobin poisoning. The only currently available antidote in the United States (the cyanide antidote kit) has been used successfully in children but has particular risks associated with its use in pediatric patients. The elements and compounds appearing in Tables 116.4 A and B are designated as hazardous substances in accordance with section 311 (b) (2) (A) of the Act. The sources and manifestations of acute cyanide poisoning seem to be qualitatively similar between children and adults, but children may be more vulnerable than adults to poisoning from some sources. Because of its infrequent occurrence, medical professionals may have difficulty recognizing cyanide poisoning, confirming its presence, and treating it in pediatric patients. On January 15, 2021, the EPA published a proposed rule in the Federal Register for the Cyanide Chemicals Manufacturing NESHAP that took into consideration the RTR analyses. Confirmed cases of childhood exposure to cyanide are rare despite multiple potential sources including inhalation of fire smoke, ingestion of toxic household and workplace substances, and ingestion of cyanogenic foods.
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