Acute Poisoning
Cyanide poisoning is a form of histotoxic hypoxia because the cells of an organism are unable to use oxygen, primarily through the inhibition of cytochrome c oxidase. If cyanide is inhaled it causes a coma with seizures, apnea, and cardiac arrest, with death following in a matter of minutes. At lower doses, loss of consciousness may be preceded by general weakness, giddiness, headaches, vertigo, confusion, and perceived difficulty in breathing. At the first stages of unconsciousness, breathing is often sufficient or even rapid, although the state of the victim progresses towards a deep coma, sometimes accompanied by pulmonary edema, and finally cardiac arrest. Skin color goes blue from cyanide-hemoglobin complexes. A fatal dose for humans can be as low as 1.5 mg/kg body weight.
Blood cyanide concentrations may be measured as a means of confirming the diagnosis in hospitalized patients or to assist in the forensic investigation of a criminal poisoning. Cyanide toxicity can occur following the ingestion of large doses of amygdalin (found in almonds and apricot kernels and marketed as an alternative cancer cure), prolonged administration of sodium nitroprusside, and after exposure to gases produced by the combustion of synthetic materials.
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