Cyanide Antidotes for Mass Casualties: Comparison of Intramuscular Injector by Autoinjector, Intraosseous Injection, and Inhalational Delivery

: Current antidotes for cyanide poisoning must be administered by intravenous injection, which would not be practical for treating mass casualties as could occur in a major industrial accident or a terrorist attack. Thus, a need exists for alternative modes of administering cyanide antidotes, and we are comparing three different administration modes: intramuscular injection, preferably via an autoinjector, intraosseous injection, and inhalational delivery. We found that all three modes can rescue animals from exposure to lethal cyanide doses. As part of these studies, we tested three new cyanide antidotes that under development: cobinamide, dimethyltrisulfide, and sulfanegen.