Cyanide Toxicity

Excerpt

Cyanide toxicity is a rare, often fatal poisoning that patients are exposed to through various modes of entry and circumstances. It has been used historically in mass suicides such as the ingestions in the Jonestown mass suicide in 1978, as an agent for individual murders, and as a chemical weapon in gaseous form on battlefields and in the form of Zyklon B during the Holocaust.

Ingestion and inhalation of toxic salts and gases are the most common sources of toxicity, respectively, though ingestion of plants, medications, and cyanogenic chemicals are alternative routes of exposure. Dermal absorption and injection are rare but possible sources of cyanide exposure. Ingestion is commonly found in suicide attempts, while inhalation exposures are often the result of structural fires. Cyanide salts, eg, potassium cyanide, are the most common type of cyanide ingestant, though exposure to cyanogenic glycosides in plants like cassava root can be fatal as well. The combustion of synthetic plastics in structural fires releases hydrogen cyanide gas, making it the most common source of inhalation exposure.