Which factors affect the onset of symptoms of cyanide toxicity?

Updated: May 30, 2020
  • Author: Inna Leybell, MD; Chief Editor: Michael A Miller, MD  more...
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The delay between exposure and the onset of symptoms depends on the type of cyanide involved, the route of entry, and the dose. Rapidity of symptom onset, depending on the type of cyanide exposure, occurs in the following order (most rapid to least rapid): gas, soluble salt, insoluble salt, and cyanogens.

A history of recent depression in the patient with sudden collapse or altered mental status, metabolic acidosis, and tachyphylaxis in an intensive care unit patient who is receiving nitroprusside should evoke suspicion of the diagnosis.

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