title: Antagonism of cyanide toxicity by isosorbide dinitrate: possible role of nitric oxide.
abstract: In a search for improved cyanide antidotes, the efficacy of isosorbide dinitrate (ISDN), was compared with that of the known cyanide antidote, NaNO2. ISDN was as effective as an optimal dose of NaNO2 in protecting mice against cyanide lethality. To study the mechanism involved, the extent of formation of the cyanide scavenger, methemoglobin, in the action of ISDN was determined. ISDN (300 mg/kg, p.o.) increased methemoglobin from 5 to 10% of total hemoglobin, while, in contrast, NaNO2 (100 mg/kg, i.p.) increased methemoglobin levels to 50% of total hemoglobin. Lowering the dose of NaNO2 to 30 mg/kg reduced methemoglobin levels to approximately 10% of total hemoglobin and in turn nearly abolished its antidotal effect. Decreasing methemoglobin to less than control levels using methylene blue failed to abolish cyanide antagonism by ISDN. Thus, methemoglobin formation by ISDN does not account for its antidotal action. Further studies comparing the respiratory depressant effects of cyanide in the presence of ISDN or NaNO2 also indicated that these two antidotes have different mechanisms of action. Efforts to produce tolerance to the antidotal effect of ISDN against cyanide toxicity were unsuccessful. It is suggested that the well-known ability of ISDN to generate nitric oxide may account for the noted cyanide antagonism.
authors.affiliation: Dept. of Pharmacology and Toxicology, Purdue University, West Lafayette, IN 47907-1334, USA.
authors.forename: P
authors.initials: P
authors.lastname: Sun
authors.forename: J L
authors.initials: JL
authors.lastname: Borowitz
authors.forename: A G
authors.initials: AG
authors.lastname: Kanthasamy
authors.forename: M D
authors.initials: MD
authors.lastname: Kane
authors.forename: P G
authors.initials: PG
authors.lastname: Gunasekar
authors.forename: G E
authors.initials: GE
authors.lastname: Isom
mesh_terms: D000284:Administration, Oral; D000704:Analysis of Variance; D000818:Animals; D000931:Antidotes / Q000494:pharmacology*; D007274:Injections, Intraperitoneal; D007548:Isosorbide Dinitrate / Q000494:pharmacology*; D007928:Lethal Dose 50; D008297:Male; D008706:Methemoglobin / Q000378:metabolism; D008751:Methylene Blue / Q000737:chemistry / Q000378:metabolism; D051379:Mice; D008928:Mitochondria / Q000187:drug effects; D009569:Nitric Oxide / Q000096:biosynthesis / Q000502:physiology*; D010101:Oxygen Consumption / Q000187:drug effects; D011042:Poisons / Q000008:administration & dosage / Q000633:toxicity; D011190:Potassium Cyanide / Q000008:administration & dosage / Q000037:antagonists & inhibitors* / Q000633:toxicity; D012119:Respiration / Q000187:drug effects*; D012977:Sodium Nitrite / Q000008:administration & dosage / Q000494:pharmacology; D014665:Vasodilator Agents / Q000494:pharmacology*
chemical_list: D000931:Antidotes; D011042:Poisons; D014665:Vasodilator Agents; D009569:Nitric Oxide; D008706:Methemoglobin; D007548:Isosorbide Dinitrate; D012977:Sodium Nitrite; D011190:Potassium Cyanide; D008751:Methylene Blue