Vick J A, Froehlich H L
Arch Int Pharmacodyn Ther. 1985 Feb;273(2):314-22.
The use of amyl nitrite and phenoxybenzamine in the treatment of acute cyanide poisoning was evaluated. Sixty anesthetized beagle dogs were injected i.v. with sodium cyanide (2.5 mg/kg) and were followed for changes in the heart rate, electrocardiogram, respiration, blood pressure and methemoglobin concentration. Twenty control dogs died within 5 to 7 min, showing severe bradycardia, a sharp drop in arterial blood pressure, and respiratory paralysis. Pretreatment with phenoxybenzamine (0.5 mg/kg) prevented these changes in 8 of 10 dogs; however, this drug was ineffective if given after the cyanide. In contrast, amyl nitrite given after cyanide administration reversed both the cardiovascular changes and the respiratory paralysis in 24 of the 30 dogs studied. These changes occurred before the formation of significant amounts of methemoglobin and indicate that early death caused by cyanide may be due in part to cardiovascular-respiratory failure in addition to the classic poisoning of the cytochrome oxidase system. These studies indicate that phenoxybenzamine prevents and amyl nitrite reverses the otherwise lethal effects of cyanide.
对亚硝酸异戊酯和酚苄明在急性氰化物中毒治疗中的应用进行了评估。给60只麻醉的比格犬静脉注射氰化钠（2.5毫克/千克），并跟踪其心率、心电图、呼吸、血压和高铁血红蛋白浓度的变化。20只对照犬在5至7分钟内死亡，表现出严重心动过缓、动脉血压急剧下降和呼吸麻痹。用酚苄明（0.5毫克/千克）预处理可防止10只犬中的8只出现这些变化；然而，如果在氰化物中毒后给药，这种药物则无效。相比之下，在给氰化物后给予亚硝酸异戊酯可使所研究的30只犬中的24只的心血管变化和呼吸麻痹得到逆转。这些变化发生在大量高铁血红蛋白形成之前，表明氰化物导致的早期死亡可能部分归因于心血管呼吸衰竭，此外还有经典的细胞色素氧化酶系统中毒。这些研究表明，酚苄明可预防，亚硝酸异戊酯可逆转氰化物的致命作用。
