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2011-05-11 13:59:33
paramedic medications drugs prehospital cyanokit hydroxocobalamin

Prehospital Medication Flashcards for Paramedic School - Massachusetts and Rhode Island
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  1. Cyanokit®

    Trade Name
    • Cyanokit®
    • (Hydroxocobalamin)
  2. Cyanokit®

    Cyanide Antidote
  3. Cyanokit®

    Mechanism of Action
    The active ingredient in Cyanokit, hydroxocobalamin, is a precursor of vitamin B12. Hydroxocobalamin works by binding directly to the cyanide ions, creating cyanocobalamin, a natural form of vitamin B12, which is excreted in the urine. Advantages of this approach are that methemoglobin is not produced and the oxygen-carrying capacity of the victim's blood is not lowered.
  4. Cyanokit®

    Cyanokit® is indicated for the treatment of known or suspected cyanide poisoning
  5. Cyanokit®

    There are no known contraindications to the use of the Cyanokit®
  6. Cyanokit®

    Adverse Reactions
    • Injection site redness
    • Temporary discoloration of the skin, urine and mucous membranes
    • Transient elevations in blood pressure
  7. Cyanokit®

    Drug Interactions
    • Blood/Blood Products
    • Diazepam
    • Dobutamine
    • Dopamine
    • Fentanyl
    • Nitroglycerin
    • Pentobarbital
    • Propofol
  8. Cyanokit®

    How Supplied
    • Each Cyanokit® carton (NDC 49502-550-2) consists of the following:
    • Two 250 mL glass vials, each containing lyophilized hydroxocobalamin for injection, 2.5 g
    • Two sterile transfer spikes
    • One sterile IV infusion set
    • One quick use reference guide
    • One package insert
    • Note: Diluent not provided in carton. Each 2.5 g vial is to be reconstituted with 100 mL of 0.9% NaCl, Lactated Ringers injection, or 5% Dextrose injection (D5W) using the transfer spike packaged with the medication
  9. Cyanokit®

    Dosage and Administration
    • The starting dose of hydroxocobalamin for adults is 5 g (i.e., both 2.5g vials) administered as an intravenous (IV) infusion over 15 minutes (approximately 15 mL/min), i.e., 7.5 minutes/vial.
    • Depending upon the severity of the poisoning and the clinical response, a second dose of 5 g may be administered by IV infusion for a total dose of 10 g. The rate of infusion for the second dose may range from 15 minutes (for patients in extremis) to two hours, as clinically indicated.
  10. Cyanokit®

    Dosage and Administration
    Safety and effectiveness of Cyanokit® have not been established in this population. In non-US marketing experience, a dose of 70 mg/kg has been used to treat pediatric patients.
  11. Cyanokit®

    Duration of Action
    24 hours to 35 days
  12. Cyanokit®

    Special Considerations
    • Pregnancy safety: Category C
    • Caution should be exercised when administering other cyanide antidotes simultaneously with Cyanokit, as the safety of co-administration 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.