SULFONAMIDE AND CYANIDE GROUP 2 - PowerPoint Presentation

Slide1

SULFONAMIDE AND CYANIDE

GROUP 2 MLS512 PRESENTATION

1

Members of group 2

OGUNYEMI TOSIN 15/MHS06/043 (PRESENTER)

ONOKPE OGHENEFEJIRO

15/MHS06/051DANDUTSE HAJARA TIJJANI 15/MHS06/023ESHEGBE EZEKIEL 14/MHS06/022

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SULFONAMIDE

Sulfonamides (sulfa drugs) are drugs that are derived from sulfanilamide, a sulfur-containing chemical. Most sulfonamides are antibiotics, but some are prescribed for treating ulcerative

colitis

(Slatore and Tilles

,

2004

)

.

3

Sulfonamide antibiotics work by disrupting the production of

dihydrofolic

acid, a form of folic acid that bacteria and human cells use for producing

proteins

(Knowles

et al.,

2001).

4

SIDE EFFECT

Sulfonamides may cause:

Dizziness

Headache

Diarrhea

Anorexia

Nausea Vomiting andSerious skin

rashes

(Armstrong, 2002).

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Sulfonamides also may cause sensitivity to the sun that leads to extensive sunburn after exposure to sunlight (photosensitivity). Patients receiving sulfonamides should avoid excessive exposure to sunlight and should wear 

sunscreen (Armstrong, 2002).

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Other rare side effects include liver damage, low white blood cell count (leucopenia), low platelet count (thrombocytopenia), and anemia. Formation of urinary crystals which may damage the

kidney.

Adequate hydration is needed to prevent the formation of urinary crystals.

7

DRUGS INTERACT WITH SULFONAMIDES

Sulfonamides

can increase the blood-thinning effects of warfarin (Coumadin), possibly leading to abnormal bleeding

.

The increased metabolism (break-down and elimination) of cyclosporine by the liver caused by sulfonamides (reduces the effectiveness of cyclosporine and can add to the kidney damage caused by cyclosporine (Knowles

et al.,

2001).

8

All

sulfonamides can crystallize in the urine when the urine is

acidic. Since

methenamine

 (

Hiprex

, Urex, 

Mandelamine

) causes acidic urine, it should not be used with

sulfonamides

(

Brackett

et al.,

2004).

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CYANIDE

Cyanide

is

any chemical that contains a carbon-nitrogen (CN)

bond. Cyanide has been used as a chemical warfare agent and an agent for terrorist attack (Armstrong, 2002). It cause an almost immediate death

.

FORMS OF CYANIDEsodium cyanide (NaCN)potassium cyanide (KCN)

hydrogen cyanide (HCN)

cyanogen chloride (

CNCl

)

Cyanide exists in gaseous, liquid and solid forms.

(

Greenfield

et al.,

2002).

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Cyanide exposure most often occurs via inhalation or ingestion but liquid cyanide can be absorbed through the skin or eyes. Once absorbed, cyanide enters the blood stream and is distributed rapidly to all organs and tissues in the body (Brennan

et al.,

1999).

Severity depends on:

The dose

the type of cyanide

Duration of exposure11

Acute cyanide

poisoning

Acute

cyanide poisoning is relatively rare, and the majority of cases are from unintentional exposure

. This condition is immediate and life-threatening

Symptoms

are sudden and

severe and they include:Difficulty in breathingSeizure

Loss

of consciousness

Cardiac arrest

(Martin and Adams, 2003

).

12

Chronic cyanide

poisoning

Chronic

cyanide poisoning results from exposure to smaller amounts over

time. Symptoms are often gradual and increase in severity as time goes on (Baud,2007).

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Early symptoms may include:

-Headache -drowsiness -nausea -

vomiting

-vertigo

-bright red flushAdditional symptoms may include

-dilated pupils -clammy skin -slower, shallower

breaths -weaker

, more rapid pulse -convulsions.

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ASSESSMENT

Blood

carbon monoxide concentration (

carboxyhemoglobin

level). blood carbon monoxide concentration can indicate how much smoke inhalation has occurred.Plasma or blood lactate level.

Elevation in the blood lactate level is a sensitive marker for cyanide toxicity

Plasma cyanide concentration Methemoglobin level (Citroner,2018).

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cyanide antidote

kit

The

cyanide antidote kit consists of three medications given together: amyl nitrite, sodium nitrite, and sodium thiosulfate. The amyl nitrite is given by inhalation for 15 to 30 seconds, while sodium nitrite is administered intravenously over three to five minutes. Intravenous sodium thiosulfate is administered for about 30

minutes (Borron et al.,

2007).

Hydroxocobalamin

(Cyanokit)Hydroxocobalamin will detoxify cyanide by binding with it to produce nontoxic vitamin B-12. This medication neutralizes cyanide at a slow enough rate to allow an enzyme called

rhodanese

to further detoxify cyanide in the

liver (

DesLauriers

et a

l

.,

2006).

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Prevention of

cyanide poisoning

Take

proper precautions against a home fire.

 Install and maintain smoke detectors. Avoid using space heaters and halogen lamps, and avoid smoking in bed.Childproof your home. If there are

young children,

childproofing

is essential especially if there are risk of occupational exposure. Keep containers holding toxic chemicals secured and the cabinets they’re kept in locked.

Follow work safety regulations.

When working

with cyanide, use removable absorbent paper to line work surfaces. Keep quantities and container sizes in the work area as small as possible.

Leave

all chemicals in the lab or factory. Don’t bring home potentially contaminated clothing or work gear.

17

REFERENCES

Martin CO, Adams HP Jr

.

(2003). Neurological aspects of biological and chemical terrorism: a review for neurologists. Arch Neurol. 60(1):21-5.Borron, S.W. Baud, F.J.

Barriot

, P.

Imbert, M. and Bismuth, C. (2007). Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg Med

.

49

(6

):794-801,

801.e1-2.

Brennan, R.J. Waeckerle

, J.F. Sharp, T.W.

Lillibridge

, S.R.

(

1999).

Chemical warfare agents: emergency medical and emergency public health issues. Ann

Emerg

Med.

34

(2

):191-204.Greenfield, R.A. Brown, B.R. Hutchins, J.B. Iandolo

, J.J. Jackson, R. Slater, L.N

.

(2002).

Microbiological, biological, and chemical weapons of warfare and terrorism. Am J Med

Sci.

323

(6):326-40

.

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Baud, F. J

. Cyanide: critical issues in diagnosis and treatment. 

Hum

Exp

Toxicol. 2007 Mar. 26(3):191-201.Citroner, G. (2018). What is cyanide poisoning Assessed from https://www.healthline.com/health/cyanide-poisoning.Retrieved 25th February,2020.

Slatore

CG,

Tilles SA (2004). Sulfonamide hypersensitivity. Immunology and Allergy Clinics of North America. 24 (3): 477–490.Knowles, S. Shapiro, L and Shear, N.H.

(2001

).

Should

Celecoxib

Be Contraindicated in Patients Who Are Allergic to Sulfonamides?.

Drug Safety

. 

24

 (4): 239–247. 

19

Brackett, C.C. Singh, H. and Block, J.H. (

2004). Likelihood and mechanisms of cross-

allergenicity

between sulfonamide antibiotics and other drugs containing a sulfonamide functional

group. Pharmacotherapy. 24 (7): 856–870. Armstrong, J. (2002).Chemical warfare. 

RN

.

65(4):32-39.20