What is the recommended antidote for Cyanide poisoning?

The recommended antidote for cyanide poisoning is indeed nitrite combined with thiosulfate. This treatment works effectively by addressing the toxic effects of cyanide on the body.

When cyanide is introduced into the body, it binds to cytochrome c oxidase in the mitochondria, inhibiting cellular respiration and leading to profound metabolic acidosis and hypoxia. The nitrite acts by converting hemoglobin to methemoglobin, which has a higher affinity for cyanide. This switch allows cyanide to bind to methemoglobin, effectively reducing its toxic effects and facilitating its elimination from the body. Following this, thiosulfate serves as a sulfuration agent, allowing the cyanide-methemoglobin complex to be converted into thiocyanate, a less toxic compound that the body can excrete through urine.

Other choices like sodium bicarbonate are used to manage acidosis but do not specifically target cyanide toxicity. Activated charcoal has its uses in poisoning cases, but it is not effective for cyanide due to the rapid absorption of cyanide from the gastrointestinal tract. Flumazenil is a benzodiazepine antagonist and is irrelevant in the context of cyanide poisoning. Thus, the combination of nitrite and thiosulf