Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
Pharmacodynamics:Antidote for cyanide poisoning (acts as a sulfur donor for endogenous sulfur-containing transferase (rhodanase), cyanide has a very high affinity for trivalent iron ions of mitochondrial oxidases, inhibiting cellular respiration, causing lactic acidosis and lethal hypoxia, sodium nitrite reacts with hemoglobin to form methaemoglobin , competing with cytochrome oxidase for the cyanide ion, cyanide is preferentially bound to cyanmethhemoglobin, restoring the activity of cytochrome oxidase, after cleavage of cyanide ida from methemoglobin sodium thiosulfate accelerates its conversion with rhodanase into thiocyanate, a less toxic ion). An additional means of antitumor therapy (the precise mechanism for reducing cisplatin-induced nephrotoxicity is not completely clear, covalent binding of sodium thiosulfate with cisplatin is proposed to form a non-toxic complex, and nephrotoxicity can be reduced due to a decrease in renal excretion of cisplatin and its neutralization in the kidneys, where sodium thiosulfate accumulates in large quantities).
Antidote for poisoning with arsenic, mercury, lead compounds (forms non-toxic sulfites).
Anti-scratch activity is due to the ability to decay in an acidic environment with the formation of sulfur and sulfur dioxide, which have a damaging effect on the scabies and his eggs.
Pharmacokinetics:It is distributed into the cellular fluid. The half-life (thiocyanate) period is 3-7 days, it can increase 2-3 times with renal insufficiency. The half-life period (thiosulfate) is 15-20 minutes. Elimination by the kidneys (mainly in the form of thiocyanate in cyanide poisoning and non-toxic complex with cisplatinum when used as an additional agent for chemotherapy). When dialysis is not removed cyanide, but the elimination of thiocyanate can be accelerated.
Indications:Intoxication with arsenic, lead, mercury, bromine salts, iodine, hydrocyanic acid and cyanides. Allergic diseases. Arthritis. Neuralgia. Scabies.
I.B85-B89.B86 Scabies
XIII.M05-M14.M13.9 Arthritis, unspecified
XIII.M70-M79.M79.2 Neuralgia and neuritis, unspecified
XIX.T51-T65.T65.0 Toxic effect of cyanides
XIX.T51-T65.T57.8 Toxic effect of other specified inorganic substances
XIX.T51-T65.T57.0 Toxic effect of arsenic and its compounds
XIX.T51-T65.T56.1 Toxic effect of mercury and its compounds
XIX.T51-T65.T56.0 Toxic effect of lead and its compounds
XIX.T66-T78.T78.4 Allergy, unspecified
Contraindications:Individual intolerance.
Carefully:Renal failure, elderly and children's age.
Pregnancy and lactation:The category of FDA recommendations is not defined. Use during pregnancy is only possible in case of emergency. It is not recommended to combine with breastfeeding.
Dosing and Administration:When cyanide poisoning: intravenously, 12.5 g (50 ml 25% solution) at a rate of 0.625-1.25 g (2.5-5 ml) per minute.
Side effects:Allergic reactions.
Overdose:In case of an overdose, it is possible: arthralgia (joint pain), blurred vision, hyperreflexia, muscle tightening, nausea and vomiting, psychomotor agitation (agitation, delirium, hallucinations),tinnitus. Treatment: hemodialysis (clearance may approximate the blood flow velocity in the dialyzer).
Interaction:Not described.
Special instructions:In case of cyanide intoxication, the antidote is administered as quickly as possible, after which careful monitoring of the patient within 24-48 hours is necessary in view of the possibility of returning symptoms of cyanide poisoning. With the re-emergence of symptoms, the administration of sodium thiosulfate is repeated in a half dose.