Chapter 10: Cyanide Poisoning   [open pdf - 101KB]

Cyanide, an ancient compound, is often associated with murders and assassinations. Cyanide, long considered a toxic, deadly substance, has been used as a poison for thousands of years. Because of the high amount needed to cause death and the inefficient weapons in which it was used, cyanide was not an effective chemical weapon in World War I; however, it was possibly used by Iraq against the Kurds in the Iran-Iraq War during the late 1980s. It was not highly successful as a chemical warfare agent in World War I, possibly because of the way it was delivered. Cyanide causes intracellular hypoxia by inhibiting the intracellular electron transport mechanism, the cytochrome enzymes. After inhalation of a large amount of cyanide--as either hydrocyanic acid or cyanogen chloride--the onset of effects is within seconds, symptoms are few, physical findings are scanty, and death occurs within minutes. The antidotes used in the United States, sodium nitrite and sodium thiosulfate, are quite effective if given before cessation of cardiac activity. Antidotes are effective if administered in time. Cyanide is ubiquitous. It is present in some foods, in the products of combustion of synthetic materials, and is widely used in industry. Much of the cyanide used is in the form of salts, such as sodium, potassium, or calcium cyanide. The cyanides of military interest are the volatile liquids hydrocyanic acid (hydrogen cyanide, HCN; North American Treaty Organization [NATO] designation: AC) and cyanogen chloride (NATO designation: CK) (Table 10-1 in this document). Although substances containing cyanide had been used for centuries as poisons, it was not until 1782 that cyanide itself was identified. It was first isolated by the Swedish chemist Scheele, who later may have died from cyanide poisoning in a laboratory accident.

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Textbook of Military Medicine: Medical Aspects of Chemical and Biological Warfare, p. 271-286
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