Two cases of sodium azide poisoning by accidental ingestion of Isoton.

Richardson, S. G. N.; Giles, Colleen; Swan, C H

doi:10.1136/jcp.28.5.350

Cited by 32 publications

(5 citation statements)

References 3 publications

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“…Table I summarises 13 previously reported cases and the 3 cases reported herein. Ingestions of 40mg or less result in headache which resolves within 1 to 2 hours of the ingestion (Edmonds & Bourne 1982;Richardson et al 1975;Roberts et al 1974). Ingestion of 50 to 60mg in a 39-year-old male resulted in a brief loss of consciousness, nausea, sweating, pallor, severe headache and hypotension (Richardson et al 1975).…”

Section: Discussionmentioning

confidence: 99%

Three Fatal Sodium Azide Poisonings

Klein‐Schwartz

Gorman

Oderda

et al. 1989

Med Toxicol Adverse Drug Exp

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We report 3 cases and review the published literature on sodium azide ingestion. A 38-year-old man intentionally ingested 2 tablespoonsful of sodium azide in water and developed seizures, coma, hypotension and fatal ventricular arrhythmias within 2 hours. A 33-year-old male ingested an unknown quantity of sodium azide. In the emergency department he was unconscious and underwent immediate intubation and gastric lavage. Nitrite therapy was instituted without improvement. He remained acidotic despite bicarbonate therapy and developed hypotension which was unresponsive to pressor agents. He died approximately 8 hours after admission despite resuscitative efforts. A 52-year-old male ingested 1.5 to 2g of sodium azide and survived for 40 hours. Nitrite therapy was ineffective. The role of sodium nitrite in treating sodium azide toxicity by producing methaemoglobin which complexes with azide is discussed.

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Section: Discussionmentioning

confidence: 99%

Three Fatal Sodium Azide Poisonings

Klein‐Schwartz

Gorman

Oderda

et al. 1989

Med Toxicol Adverse Drug Exp

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“…However, to date, no cases have been reported in which methylene blue has been successfully used as an antidote. Other case reports described a variety of therapeutic supportive care interventions, including sodium thiosulfate, intralipid, gastric lavage with activated charcoal, hydroxocobalamin, dopamine, dobutamine, methylprednisolone, calcium gluconate, insulin/glucose, sodium bicarbonate, and adrenaline [ 4 , 14 , 23 , 24 ]. Despite extensive and aggressive supportive care measures such as exchange transfusion or dialysis, in addition to the above-described therapeutic strategies, all of these individuals had to be resuscitated, and all were unsuccessful [ 4 , 14 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other case reports described a variety of therapeutic supportive care interventions, including sodium thiosulfate, intralipid, gastric lavage with activated charcoal, hydroxocobalamin, dopamine, dobutamine, methylprednisolone, calcium gluconate, insulin/glucose, sodium bicarbonate, and adrenaline [ 4 , 14 , 23 , 24 ]. Despite extensive and aggressive supportive care measures such as exchange transfusion or dialysis, in addition to the above-described therapeutic strategies, all of these individuals had to be resuscitated, and all were unsuccessful [ 4 , 14 , 23 , 24 ]. However, it is suggested that there might be a window of opportunity for the use of exchange transfusions or dialysis if applied before systemic effects [ 4 ] and in patients with no severe hemodynamic symptoms [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Internet-Purchased Sodium Azide Used in a Fatal Suicide Attempt: A Case Report and Review of the Literature

Heijden

Hondel

Olyslager

et al. 2023

Toxics

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There has been a significant increase in sodium azide intoxications since the 1980s. Intoxications caused by sodium azide are becoming increasingly prevalent in the Netherlands as a result of its promotion for the purpose of self-euthanasia. The mechanism of toxicity is not completely understood but is dose-dependent. The presented case describes a suicide by sodium azide of a young woman (26 years old) with a history of depression and suicide attempts. The decedent was found in the presence of prescription medicine, including temazepam, domperidone in combination with omeprazole, and the chemical preservative sodium azide. Quantitative toxicology screening of whole blood revealed the presence of 70 µg/L temazepam (toxic range > 1000 µg/L) and 28 mg/L sodium azide (fatal range: 2.6–262 mg/L). Whole blood qualitative analysis revealed the presence of temazepam, temazepam-glucuronide, olanzapine, n-desmethylolanzapine, and acetaminophen. In circles promoting sodium azide, it is recommended to use sodium azide in combination with medications targeting sodium azide’s negative effects, such as analgesics, antiemetics, and anti-anxiety drugs. The medicines recovered at the body’s location, as well as the results of the toxicology screens, were consistent with the recommendations of self-euthanasia using sodium azide.

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“…Azide causes neurological symptoms, such as headaches, vertigo, staggering, coma and convulsions, as well as circulatory symptoms, such as pulmonary edema and hypotension (Kozlocka-Gajdzinska and Brzyski, 1966;Edmonds and Bourne, 1982;Howard et al, 1990;Ingraham et al, 1991;Richardson and Giles, 1995;Marquet et al, 1996). Vertigo and hypotension appear following the ingestion of a minute amount of sodium azide (5Á10 mg) (Richardson and Giles, 1995). Furthermore, low azide levels in the brain have been reported in fatal intoxication cases (Marquet et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Effect of sodium azide on the metabolic activity of cultured fetal cells

2006

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Sodium azide is a highly toxic substance. However, the mechanism of its toxicity has not been fully established. In the present study, we attempted to investigate the toxicity of sodium azide in various cultured fetal cells, using changes in cellular respiration as an indicator of metabolic inhibition to elucidate tissue-specificity. The human fetal cell lines used in this study included myocardial cells, nerve cells, fibroblasts, hepatocytes and renal tubular epithelial cells. The cells were seeded in wells at a density of 2 x 10(6)cells/2mL, sodium azide was added at a concentration of 0.01 ng/mL to 10 microg/mL, and the respiration of each type of cell was measured 1 h later using a dissolved oxygen meter. The concentration at which sodium azide inhibited metabolic activity was lower in the nerve and myocardial cells than in the fibroblasts, hepatocytes and renal tubular epithelial cells. These findings may serve to clarify the dynamic mechanisms of sodium azide toxicity in vivo.

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Two cases of sodium azide poisoning by accidental ingestion of Isoton.

Abstract: SYNOPSIS Accidental ingestion of sodium azide in 01I% solution by a patient and a laboratory technician in a haematological laboratory has demonstrated that very small quantities of sodium azide can give rise to toxic symptoms and that Isoton should be handled with care.

Cited by 32 publications

References 3 publications

Three Fatal Sodium Azide Poisonings

Three Fatal Sodium Azide Poisonings

Internet-Purchased Sodium Azide Used in a Fatal Suicide Attempt: A Case Report and Review of the Literature

Effect of sodium azide on the metabolic activity of cultured fetal cells

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