Ndeipi nzira ye sodium thiosulfate mukurapa cyanide chepfu?

Chepfu yeCyanide chinhu chakakomba uye chinotyisidzira hupenyu chinoda kurapwa nekukurumidza. Sodium thiosulfate ndeimwe yemishonga yakakosha inoshandiswa mukurapa kwe Cyanide Poisoning. Ichi chinyorwa chichaongorora zvakadzama maitiro ekuti sei Sodium Thiosulfate inoshanda kurwisa mhedzisiro ye cyanide.

Kunzwisisa Cyanide Poisoning

Cyanide chinhu chine chepfu zvakanyanya. Painopinda mumuviri, inokurumidza kuparadzaniswa kuva cyanide ions (CN⁻). Aya maion ane hukama hwepamusoro kune ferric ion (Fe³⁺) mu cytochrome oxidase, enzyme yakakosha pakufema kweserura. Nekusunga ku cytochrome oxidase, cyanide inhibits cheni yekutakura erekitironi, ichidzivirira masero kubva kushandisa oxygen zvinobudirira. Nekuda kweizvozvo, masero haakwanise kugadzira adenosine triphosphate (ATP), iyo simba remari yesero, zvichiita kuti kukurumidza kufa kwesero. Zviratidzo zvechepfu yecyanide zvinogona kusanganisira kutemwa nemusoro, dzungu, kukurumidza kufema, kusvotwa, kurutsa, uye muzviitiko zvakakomba, kurasikirwa nepfungwa, pfari, uye kufa.

Basa reSodium Thiosulfate muKurapa

Mechanism of Action

Sodium thiosulfate inoshanda semupi wesarufa. Pamberi peiyo enzyme rhodanese, iyo iripo muchiropa uye mamwe matukisi, sodium thiosulfate inopindirana neiyo cyanide ions. Atomu yesarufa kubva ku sodium thiosulfate inoendeswa kune cyanide ion, ichishandura kuita thiocyanate (SCN⁻). Thiocyanate haina muchetura zvakanyanya pane cyanide uye inogona kuburitswa zvakachengeteka kubva mumuviri kuburikidza neitsvo.

Iyo kemikari reaction inogona kumiririrwa seizvi:

CN⁻ + Na₂S₂O₃ → SCN⁻ + Na₂SO₃

Iyi nzira yekutendeuka inobatsira kuderedza kuwanda kwechepfu cyanide ions mumuviri, zvichibvumira kufema kweserura kuti kutangezve.

Administration muKurapa

Paunenge uchirapa chepfu ye cyanide, sodium thiosulfate inowanzoitwa intravenously. Muvanhu vakuru, chiyero chekutanga che12.5 - 25 gramu (kazhinji se 25% - 50% solution). Izvi zvinowanzoteverwa nemamwe madosi sezvinodiwa, zvichienderana nekuoma kwechepfu uye mhinduro yemurwere. Semuenzaniso, mune zvimwe zviitiko, imwe yechipiri dhizimusi ye25 - 50 magiramu (50% mhinduro) inogona kupihwa, kana iyo dose inogona kuverengerwa zvichienderana nehuremu hwemuviri wemurwere pa 0.5 - 1 gramu pakirogiramu yehuremu hwemuviri.

Muvana, muyero unotarwa zvichienderana nehuremu hwemuviri, kazhinji pa250 - 500 milligrams pakirogiramu. Mushonga unopiwa zvishoma nezvishoma kuti udzivise zvinogona kuitika zvakadai se hypotension (low blood pressure), iyo inogona kuitika kana yakabaiwa nekukurumidza.

Kusanganiswa nemamwe Kurapa

Sodium thiosulfate inowanzoshandiswa pamwe chete nemamwe marapirwo e cyanide poisoning. Imwe yeanonyanya kusanganiswa ndeye nitrites, senge sodium nitrite kana amyl nitrite. Nitrites inoshanda nekushandura hemoglobin kuva methemoglobin. Methemoglobin ine hukama hwepamusoro hwe cyanide ions kupfuura cytochrome oxidase. Saka, kana methemoglobin ikaumbwa mumuviri, cyanide ions inosungirirwa kwairi, ichiburitsa cytochrome oxidase uye ichibvumira kufema kweserura kutanga zvakare. Nekudaro, iyo cyanide - methemoglobin complex haina kugadzikana, uye cyanide inogona kuburitswa muropa nekufamba kwenguva. Apa ndipo panouya sodium thiosulfate. Nekushandura cyanide yakaburitswa mucyanide - methemoglobini kuita thiocyanate, sodium thiosulfate inopa mhinduro yenguva refu yekubvisa cyanide kubva mumuviri.

Mukuwedzera kune nitrites, mamwe marapirwo anotsigira anopiwawo. Izvi zvinogona kusanganisira yakakwira -kuyerera okisijeni kurapwa kuti uvandudze kuendeswa kweokisijeni kumatishu, pamwe nematanho ekugadzirisa zviratidzo zvakaita sekugwinha, hypotension, uye acid - base kusaenzana kunowanzo perekedza chepfu yecyanide.

Monitoring uye Kutevera - kumusoro

Mushure mekutonga kwe sodium thiosulfate uye kumwe kurapwa kwecyanide chepfu, varwere vanofanirwa kunyatsotariswa. Vatapi vehutano vanozotarisa zviratidzo zvakakosha senge kurova kwemoyo, BP, kufema, uye oxygen saturation nguva dzose. Kuongororwa ropa kunogona kuitwa kuyera mazinga e cyanide, thiocyanate, uye mamaki ekukuvadzwa kwetishu. Pamusoro pezvo, chimiro chemurwere chetsinga chichacherechedzwa zvakanyanya, sezvo chepfu ye cyanide inogona kukonzera kukuvadzwa kukuru kune yepakati tsinga system.

Kutevera-kutarisira kunokosha zvakare. Kunyangwe kana murwere achiita seapora pekutanga, panogona kuve nemhedzisiro yenguva refu senge kuperevedza kwetsinga kana kukuvara kwenhengo. Kugara uchitarisa-ups uye matanho ekugadzirisa akakodzera angave akadikanwa kuti ave nechokwadi chemhedzisiro inogoneka kumurwere.

Mukupedzisa, sodium thiosulfate inoita basa rakakosha mukurapa chepfu yecyanide nekushandura ion cyanide ine muchetura kuita muchetura thiocyanate. Kushandiswa kwaro, pamwe chete nemamwe marapirwo uye kutarisa kwakakodzera, kunogona kuvandudza zvakanyanya mikana yekupona uye kupora kune varwere vanotambura necyanide chepfu.