- Discussion: - therapy for > 24 hrs, excessive dosage, or RF may cause acculuation of thiocyanate, the metabolite, is excreted by kidney; - thiocyanatetoxicity occurs at plasma levels of 5-10mg/dl; - look for
metabolic acidosis (early sign) blurred vision, tinnitus, or delirium, hepatic dysF(x), dyspnea, V, dizziness, ataxia, and syncope; -
metabolic acidosis is the screening sign for toxicity;
- Treatment: - discontinuance and dialysis are mainstays of treatment; - prophylactic infusion of hydrocobalamin (25mg/hr) has been shown to decrease cyanate concentration;
