Sodium thiosulfate: Difference between revisions
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== | ==Administration== | ||
* | *Type: [[Antidote]] | ||
* | *Dosage Forms: | ||
*Routes of Administration: IV | |||
*Common Trade Names: | |||
==Adult Dosing== | |||
===[[Cyanide toxicity]]=== | |||
*Adult: 12.5 g IV (after giving [[sodium nitrite]] 300 mg) | |||
===Prophylaxis during nitroprusside infusion=== | |||
*Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside | |||
==Pediatric Dosing== | |||
===[[Cyanide toxicity]]=== | |||
*Pediatric: 400 mg/kg IV | |||
*Per micromedex: 412.5 mg/kg or 7 g/m(2) administered at a rate of 0.625 to 1.25 g/min IV | |||
===Prophylaxis during nitroprusside infusion=== | |||
*Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside | |||
==Special Populations== | |||
*[[Drug pregnancy categories|Pregnancy Rating]]: C | |||
*Lactation risk: Infant risk cannot be ruled out | |||
*Renal dosing: not established | |||
*Hepatic dosing: not established | |||
==Indications== | ==Indications== | ||
| Line 9: | Line 32: | ||
==Contraindications== | ==Contraindications== | ||
* | *Allergy to class/drug | ||
==Adverse | ==Adverse Reactions== | ||
===Serious=== | |||
===Common=== | |||
*Burning sensation and muscle cramping from infusion | *Burning sensation and muscle cramping from infusion | ||
== | ==Pharmacology== | ||
* | *Half-life: 80 min | ||
* | *Metabolism: Liver | ||
* | *Excretion: Renal | ||
* | |||
* | ==Mechanism of Action== | ||
*Sulfur donor that promotes conversion of cyanide to thiocyanate | |||
==Comments== | |||
*Whereas the nitrites have adverse effects (induction of [[methemoglobinemia]]), sodium thiosulfate is non-toxic | |||
**Should avoid nitrites in [[cyanide toxicity]] when [[CO poisoning]] is suspected to avoid lowering oxygen-carrying capacity | |||
==See Also== | ==See Also== | ||
*[[Cyanide toxicity]] | *[[Cyanide toxicity]] | ||
*[[Sodium nitrite]] | |||
==References== | ==References== | ||
<references/> | |||
*Olson, K. Poisoning and Drug Overdose, 1999. | *Olson, K. Poisoning and Drug Overdose, 1999. | ||
[[Category:Pharmacology]] | |||
[[Category:Toxicology]] | [[Category:Toxicology]] | ||
Latest revision as of 22:55, 5 March 2021
Administration
- Type: Antidote
- Dosage Forms:
- Routes of Administration: IV
- Common Trade Names:
Adult Dosing
Cyanide toxicity
- Adult: 12.5 g IV (after giving sodium nitrite 300 mg)
Prophylaxis during nitroprusside infusion
- Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside
Pediatric Dosing
Cyanide toxicity
- Pediatric: 400 mg/kg IV
- Per micromedex: 412.5 mg/kg or 7 g/m(2) administered at a rate of 0.625 to 1.25 g/min IV
Prophylaxis during nitroprusside infusion
- Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: not established
- Hepatic dosing: not established
Indications
- Acute cyanide toxicity
- Smoke inhalation with potential for cyanide exposure
- Prophylaxis during nitroprusside infusions
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
- Burning sensation and muscle cramping from infusion
Pharmacology
- Half-life: 80 min
- Metabolism: Liver
- Excretion: Renal
Mechanism of Action
- Sulfur donor that promotes conversion of cyanide to thiocyanate
Comments
- Whereas the nitrites have adverse effects (induction of methemoglobinemia), sodium thiosulfate is non-toxic
- Should avoid nitrites in cyanide toxicity when CO poisoning is suspected to avoid lowering oxygen-carrying capacity
See Also
References
- Olson, K. Poisoning and Drug Overdose, 1999.