Acute cyanide poisoning

Cyanide poisoning results in cytotoxic hypoxia due to the inactivation of mitochondrial cytochrome oxidase. The pathophysiology of this intoxication is discussed and antidotal therapies are examined and contrasted.

Two case reports of patients with acute poisoning are presented. The importance of general supportive measures, the administration of 100 per cent oxygen and reversal of metabolic acidosis are stressed.

Medical management of angina pectoris

The successful medical management of a patient with angina pectoris requires careful attention to many factors including omission of smoking, control of hypertension, and weight reduction for the obese person. Newer knowledge of the importance of the product of the systolic blood pressure and the pulse rate in determining the threshold of angina affords a more meaningful approach to therapy. Each individual must be educated regarding the factors that aggravate and precipitate his distress so that these can be minimized, or prophylactic nitrite therapy can be appropriately applied. Emotional stress is of equal importance to effort in the production of angina. The mainstay stay of treatment is nitroglycerin and sublingual nitrites combined with beta-blocking drugs. Each drug or combination must be properly readjusted for the individual to assure optimum benefit. Digitalis, diuretics, antiarrhythmic drugs, antihypertensive agents, and radioiodine may be useful in selected cases.