The antidote, which is used for poisoning with salts or other compounds of heavy metals, has several names that are synonymous: sodium hyposulfite, sodium thiosulfate, sodium hyposulfate. But the most common name for this drug is sodium thiosulfate. Its use is due to the fact that the drug is relatively inexpensive, as well as non-toxic. The effectiveness of treatment of poisoning with compounds of arsenic, copper, lead, mercury, bromine or iodine salts has been proved. As a result of interaction with them, sulfites are formed in the body, which are not toxic, as well as other non-toxic or low toxic substances. Available in powder form and 30% solution in ampoules with a capacity of 5 ml, 10 ml and 50 ml.
Due to its unique properties, it is used (in combination with sodium nitrite) as an antidote for poisoning by cyanide compounds (cyanides), resulting in the formation of rhodanic compounds, which are less toxic. The mechanism of detoxification of poisoning with hydrocyanic acid and its salts is based on the conversion of cyanide into a relatively non-toxic thiocyanate ion. Under the action of the enzyme rhodonase, the formation of thiosulfate cyanide seratransferase occurs (present in many tissues, but to a greater extent in the liver). The body itself has the ability to neutralize cyanides with the help of rhodonase, but only sodium thiosulfate can accelerate this slow-moving process, the use of which helps to introduce exogenous sulfur donors into the body.
Sodium thiosulfate is useful in a surprisingly wide range of clinical situations. In addition to the detoxifying effect, one can also name the anti-inflammatory, antiparasitic (anti-scab) and desensitizing properties that characterize sodium thiosulfate. Its use is known for the treatment of scabies. The drug for the treatment of scabies patients is applied topically: 60% sodium thiosulfate solution is rubbed into the affected areas of the skin of the limbs or trunk. When it dries, these places are moistened with a 6% hydrochloric acid solution.
Typically, sodium thiosulfate solution is used intravenously, orally and through the skin. It is currently used intravenously as an antidote for the treatment of cyanide poisoning and the prevention and treatment of cancer. Usually, 5-10 ml of sodium thiosulfate solution are administered, and 50 ml of the solution is administered for lesions with cyanide compounds. With cyanide intoxication, delays should not be allowed with the introduction of an antidote, since a quick fatal outcome is not ruled out . Therefore, patients are carefully observed in the first two days due to the possibility of a recurrence of symptoms of cyanide poisoning. In this case, sodium thiosulfate is additionally administered in half dose. It is also used as a preservative drug.
Extensive experience has been accumulated (over a hundred years) in the safe use of sodium thiosulfate as a therapeutic agent. Data on its medical use has been documented since 1895. For example, for the combination therapy of arthritis, allergic diseases, neuralgia, such a safe drug as sodium thiosulfate has long been known. Its use is effective as an antidepressant, antiarrhythmic and metabolic agents. Thiosulfate is unique; it reacts with free radicals to form sodium sulfate.
Hypersensitivity to the substance is the main indication by which sodium thiosulfate may be limited in its use.
Contraindications: hypersensitivity, pregnancy and lactation. It should be used to treat pregnant and lactating women only in case of emergency. Since reproductive studies in animals with sodium thiosulfate have not been carried out, it is not known whether it can affect the ability to reproduce and cause adverse effects for the embryo.