Poisning Center - Pediatric On Call

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Drug

Treatment Details

Hydrocyanic acid (prussic acid or cyanogen

Hydrocyanic acid is a vegetable acid found in many fruits and leaves such as almond, apricot, apple, cheery, peach, plum, pear, and in certain oils and besns where it exists as a glucoside amygdalin. The pure acid is colorless, transparent volatile liquid with an odor like bitter almonds and is rapidly decomposed by exposure to light

Route : Inhalation, ingestion, ingestion through skin

Fatal dose : 50 to 60mg of pure acid, 200 to 300mg of sodium or potassium cyanide

Fatal Period : 2 to 10 minutes

Mechanism of action : •Cyanide inhibits the action of various enzymes of various enzymes.
• Cyanides act by reducing the oxygen carrying capacity of blood.
•There is interference with with intracellular oxidative process in tissues

Clinical picture : This is the most rapid of all poisons.
•CNS: headache, vertigo, perspiration, anxiety, convulsions, paralysis
•GIT: bitter, acid, burning taste, constriction or numbness of throat
•RS: odor of bitter almonds in breath. Initially tachypnoea and dyspnoea. Later rapid slowing of respiratory rate with severe respiratory depression and cyanosis
•CVS: Initially hypertension, later tachycardia with hypotension
•Glassy and prominent eyes with dilated pupils, unreactive

Treatment : •Treatment should be started immediately
•The principle of treatment is to reverse the cyanide – cytochrome combination.

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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