Nitrates and nitrites
 
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1. Inorganic nitrates: sodium nitrate{ tastes like sodium chloride, used by weavers as a mordant}, potassium nitrate, silver nitrate 2. Organic nitrates: nitroglycerin, iso sorbide dinitrate 3. Inorganic nitrites: amyl nitrite, isobutyl nitrite, sodium nitrite 4. Organic nitrites: bismuth sub nitrate in contaminated well water may be converted by intestinal bacteria into nitrites and causes poisoning
Route :
Ingestion
Fatal Dose :
sodium nitrate - 1 to 2 gms, nitroglycerin – 200mg, silver nitrate – 2 to 10 gms
Fatal Period :
few hours to few days
Mechanism of action :
Sodium nitrate causes relaxation of smooth muscles, especially of blood vessels and in toxic doses comnerts hemoglobin to methemoglobin
Clinical Picture :
• Throbbing headache, vertigo, low BP, palpaitations, • cold and cyanotic, nausea , vomiting, diarrhea, syncope • cyanosis, anoxia • Hyperapnoea, later dyspnoea, slow pulse, increased intracranial tension • paralysis, convulsions, coma
Treatment :
• Emesis • Gastric lavage • If methhemoglobinemia More than 30 percent, inject methylene blue {1 percent soln} or 1 to 2 mg, kg orally • Exchange transfusion, especially in infants • Symptomatic
08/06/2019 12:40:05 Nitrates and Nitrites
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