![]() ![]() ![]() ![]() Thank you for your assistance in this matter. Specifically, we request guidance on the ability to use amyl nitrite (now a prescription drug), training requirements to administer such a drug, any acceptable alternatives to amyl nitrite such as hydroxy cobalamine, and guidance on its use. 352) and 505 of the FD&C Act and applies to unapproved injectable drug products. This notice is issued under sections 502 (21 U.S.C. We are requesting any new information since the August, 1986 memo. Unapproved cyanide antidote kits may also contain other unapproved drugs (e.g., amyl nitrite) or medical products (e.g., syringes) that are intended for potential use with sodium nitrite and sodium thiosulfate. We have reviewed your memo of August 8, 1986, regarding the use of Cyanide Antidote Kits. On January 14, 2011, FDA approved NDA 201444 for Nithiodote, a co-packaged Sodium Nitrite Injection and Sodium Thiosulfate Injection drug product, labeled for treatment of acute cyanide poisoning that is judged to be life- threatening. This information should update you on Cyanide Antidote Kits. ( a) This part establishes Federal standards for the certification and recertification of applicators of restricted use pesticides, and requirements for pesticide applicator certification plans administered by State, Tribal, and Federal agencies. Warner informed us that there were no future plans to alter the emergency kit or develop alternative antidotes. Warner, PhD from Eli Lilly and Company, the manufacturers of the commercially available Cyanide Emergency Kit, to determine if any new products or methods are being developed to address cyanide poisoning. The mainstay of therapy for cyanide poisoning is aggressive supportive care (see Table 143-1) and prompt administration of the cyanide antidote kit (Table 143-2). According to current literature, hydroxy cobalamine has had limited use as an alternative intravenous medication to the widely accepted sodium nitrite protocol. US EPA (1990) Summary review of health effects associated with hydrogen cyanide. : This is an outline of antidotes available for informational purposes. NIOSH (2004) recommends a 10-minute ceiling of 5 mg/m3 for cyanide in compounds such as sodium cyanide or potassium cyanide. Persons whose clothing or skin are contaminated with liquid acrylonitrile can secondarily contaminate response personnel by direct contact or through off-gassing vapor. state, or federal authorities to ensure compliance with all applicable rules and regulations. of Federal Regulations 40 CFR 180.125, US Environmental. CAS 107-13-l UN l093 PDF Version 194 KB Synonyms include AN, cyanoethylene, propenenitrile, VCN, vinyl cyanide, carbacryl, fumigain, and ventox. This memo is in response to your correspondence of April 27, regarding updated information on Cyanide Antidote Kits since my August, 1986 letter.Īs per my 1986 memo, Amyl Nitrite continues to require a physician's prescription and the administration of this drug in an emergency situation by the designated first aide responder is the medically accepted initial response. OBTAIN THE CYANIDE ANTIDOTE KIT AND PREPARE IT FOR USE. ![]()
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