Cyanokit

Question 1

Cyanokit:
Classification -
1. ___

Answer 1

Classification -

1. Hydoxocobalamin - a form of B-12

Question 2

Cyanokit:
Action -
1. ___

Answer 2

Action -

1. Hydroxocobalamin binds to the cynide ion forming cyanocobalamin which is excreted in the urine.

Question 3

Cyanokit:
Onset of Action -
1. ___

Answer 3

Onset of Action -

1. Immediate

Question 4

Cyanokit:
Duration of Action -
1. ___

Answer 4

Duration of Action -

1. Up to 24 hours.

Question 5

Cyanokit: 
Indication - 
1. \_\_\_ 
2. \_\_\_ 
     a. \_\_\_ 
     b. \_\_\_ 
     c. \_\_\_ 
     d. \_\_\_

Answer 5

Indication -

1. Treatment for known or suspected cyanide poisoning. Signs and symptoms of high concentrations of cyanide exposure with an appropriate clinical history are indications for treatment.
2. High concentrarions of cyanide signs and symptoms:
   a. Markedly altered level of consciousness.
   b. Seizure.
   c. Respiratory depression or arrest.
   d. Cardiac dysrhythmia (other than sinus
   tachycardia) .

Question 6

Cyanokit:
Contraindication -
1. ___

Answer 6

Contraindication -

1. Patients with known anaphylactic reactions to hydroxocobalmin or cyanocobalamin.

Question 7

Cyanokit:
Use with Caution -
1. ___

Answer 7

Use with Caution -
1. Caution should be exercised when administering other cyanide antidotes simultaneously with Cyanokit, as safety has not been established. If a decision is made to administer another cyanide antidote with Cyanokit, these drugs should not be administered concurrently in the same IV line.

Question 8

Cyanokit:
Dosage and Administration -
1. ___
2. Adult: ___

Answer 8

Dosage and Administration -

1. If able, collect a pre-treatment blood sample in the appropriate tube to assess cyanide level.
2. Adult: Initial dose is 5 gm administered over 15 minutes slow IV. (Each 5 gm vial of hydroxocobalmin for injection is to be reconstituted with 200 mL of 0.9% NS. Invert repeatedly, but do not shake to reconstitute). An additional 5 gm dose may be administered.

Question 9

Cyanokit:
Adverse Reaction -
1. ___
2. (List of 6)

Answer 9

Adverse Reaction -

1. Reddish discoloration of the skin and urine (not to be confused with the rare sign of carbon monoxide poisoning). The devices that rely on colorimetry (pulse oximetry and CO level) will be interfered with by the color change and are not reliable for patient assessment.
2. Rash, Increased blood pressure, Nausea, Headache, Injection site reactions, Allergic reactions

Question 10

Cyanokit:
Dosage and Administration -
1. Pediatric: ___

Answer 10

Dosage and Administration -
1. Pediatric: Dose is 70 mg/kg (reconstitute concentration is 25 mg/mL) over 15 minutes slow IV. (Each 5 gm vial of hydroxocobalamin for injection is to be reconstituted with 200 mL of 0.9% NS.) Maximum single dose is 5 gm.