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HOME > J Korean Soc Clin Toxicol > Volume 1(1); 2003 > Article
Chemical Asphyxiants - Cyanides and Hydrogen Sulfides
Yang Ho Kim, Young Hee Choi, Choong Ryeol Lee, Ji Ho Lee, Cheolln Yoo, Hun Lee
Journal of The Korean Society of Clinical Toxicology 2003;1(1):12-20
DOI: https://doi.org/
Published online: June 30, 2003
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1Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan
2Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan
3Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan
4Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan
5Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan
6Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan

Cyanides and hydrogen sulfide ($H_2S$) are major chemical asphyxiants. They have common mechanism of action which inhibit cellular respiration and induce histotoxic hypoxia. They do not generate ATP, and all processes dependent on ATP are stopped. No extraction of $O_2$ from blood decreases AV $O_2$ differences, and the shift to anaerobic glycolysis brings about lactic acidosis with high anion gap. The mainstay of the treatment is rapid treatment with appropriate use of antidotes. However, there are several differences between cyanides and $H_2S$. First, $H_2S$ is not metabolized by enzymes such as thiosulfate. Thus thiosulfate does not play any role in treatment of $H_2S$. Second, $H_2S$ is a more potent inhibitor of cytochrome aa3 than cyanide. Third, $H_2S$ induces more divergent neurologic sequele than cyanide. Finally, $H_2S$ is not absorbed via skin.

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JKSCT : Journal of The Korean Society of Clinical Toxicology