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

See Also

• Cyanide toxicity