title: Acetonitrile serum concentrations and cyanide blood levels in a case of suicidal oral acetonitrile ingestion.
abstract: Acute acetonitrile toxicity is mainly dependent on the release of cyanide via hepatic metabolism. Although evaluated in animals, few data are available concerning the toxicokinetic parameters of acetonitrile and acetonitrile-liberated cyanide in human. This paper reports a case of suicidal oral acetonitrile ingestion of about 5 mL without severe symptoms of intoxication in a previously healthy adult male with a body weight of 60 kg. Acetonitrile serum concentrations as well as cyanide blood levels were determined over the whole hospitalization. The elimination half-lives calculated from these data were 32 h for acetonitrile and 15 h for cyanide. After sodium thiosulfate bolus application, the cyanide blood level rapidly decreased to 10% of the initial value, indicating that sodium thiosulfate sufficiently detoxifies acetonitrile-liberated cyanide. Since cyanide levels again increased to maximal values about 4.5 h after sodium thiosulfate application, continued thiosulfate therapy is required as predicted by the long elimination half-lives of acetonitrile and acetonitrile-liberated cyanide. Determination of cyanide and acetonitrile concentrations is recommended for the estimation of optimal individual sodium thiosulfate dosage.
authors.affiliation: Department of Pharmacology and Toxicology, University of Göttingen, Germany.
authors.forename: H C
authors.initials: HC
authors.lastname: Michaelis
authors.forename: C
authors.initials: C
authors.lastname: Clemens
authors.forename: H
authors.initials: H
authors.lastname: Kijewski
authors.forename: H
authors.initials: H
authors.lastname: Neurath
authors.forename: A
authors.initials: A
authors.lastname: Eggert
mesh_terms: D000097:Acetonitriles / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000506:poisoning*; D000284:Administration, Oral; D000328:Adult; D002849:Chromatography, Gas; D003486:Cyanides / Q000097:blood*; D006801:Humans; D008297:Male; D013406:Suicide, Attempted
chemical_list: D000097:Acetonitriles; D003486:Cyanides; C032159:acetonitrile