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Sodium thiosulfate
From WikEM
Background
- Sulfur donor that promotes conversion of cyanide to thiocyanate
- Whereas the nitrites have adverse effects, sodium thiosulfate is non-toxic
Indications
- Acute cyanide poisoning
- Smoke inhalation with potential for cyanide exposure
- Prophylaxis during nitroprusside infusions
Contraindications
- None
Adverse Effects
- Burning sensation and muscle cramping from infusion
- Pregnancy Category C
Dosing
- Cyanide Poisoning:
- Adult: 12.5 g IV
- Pediatric: 400 mg/kg IV
- Prophylaxis during nitroprusside infusion:
- Add 10 mg sodium thiosulfate for each 1 mg of nitroprusside
References
- Olson, K. Poisoning and Drug Overdose, 1999.
