It is the sodium salt of thiosulphuric acid which, at room temperature, appears as a colorless and odorless solid.
Also known as sodium thiosulfate, or more simply thiosulphate, this compound is also used in the medical field for the treatment of hydrocyanic acid or cyanide poisoning. In fact, it can be found in medicines with therapeutic indications of this type.In this article we will deal precisely with this type of use.
Did you know that ...
Sodium thiosulfate is also used to remove the excess of hypochlorite inside the waters (for example, those destined to fill ponds and aquariums, as the hypochlorite could be harmful to the animals that stay there) and in the photographic field during film development.
Examples of Medicines containing Sodium Thiosulfate
- Sodium Thiosulfate Monico®
- Sodium Thiosulfate S.A.L.F.®
- In the prophylaxis of cisplatin nephropathy;
- As a desensitizer in the extravasation of chemotherapy drugs.
Please Note
Since medicinal products based on the active ingredient in question contain a "significant amount of sodium, care must be taken when administering them to patients with reduced kidney function or who follow a low sodium diet.
(SOP), over-the-counter drugs (OTC), herbal and phytotherapeutic products, etc.
Since sodium thiosulfate has a chelating action, it can interact with metals or other ions (it is able to chelate them).
experiencing undesirable effects of different type and intensity, or not showing any at all.However, the following undesirable effects may occur after administration of sodium thiosulfate, the frequency of which is not known, however:
- Allergic skin reactions, such as contact dermatitis;
- Nausea and vomit;
- Diarrhea;
- Hypotension - particularly when sodium thiosulfate is infused too quickly - and hypovolemia
- Burning and allergic irritation at the injection site.
Sodium thiosulfate overdose
Since sodium thiosulfate should only be administered by trained personnel, overdose is an unlikely occurrence.
In any case, in case of overdose (concentration in the blood of 20 mg per 100 ml) there can be a danger of life. In case of administration of excessive doses, hemodialysis can be evaluated to try to remove the active principle from the organism. .
. This enzyme catalyses the conversion of cyanide into thiocyanate (a relatively non-toxic and considered harmless compound) which will then be excreted by the body through the urine.The active ingredient is effective in the prophylaxis of cisplatin-induced nephropathy as it is capable of selectively concentrating in the urine where it forms a complex with the aforementioned antitumor (thiosulfate-cisplatin complex) that is non-toxic to both healthy and diseased cells.
The same mechanism of action that leads to the formation of complexes with anticancer drugs is at the basis of the activity as a desensitizer in the extravasation of chemotherapeutic drugs.
0.9% or 5% glucose, by slow infusion into a vein over 10-30 minutes following 300 mg of sodium nitrite.
The patient will be kept under observation for 24-48 hours following administration.
In case of relapse from poisoning, the administration of half the dose of both sodium thiosulfate and sodium nitrite should be repeated.
Sodium thiosulfate can be administered simultaneously with a hydroxocobalamin solution (another antidote used for cyanide poisoning), but - due to the chemical incompatibilities between these active ingredients - in a different administration site, at a dosage of 5 g suitably diluted. in 250 ml of 0.9% sodium chloride or 5% glucose solution.
If necessary, in the event of any relapse from poisoning, the administration of sodium thiosulfate and hydroxocobalamin can be repeated.
Children
The recommended dose is 412.5 mg per kg of body weight (0.7 g per m² of body surface area), appropriately diluted in 100 ml of 0.9% sodium chloride or 5% glucose solution, always to be administered through a slow intravenous infusion (0.625-1.25 g / min).
Do not exceed 12.5g.
Your doctor can adjust the starting dose of sodium thiosulfate based on your blood hemoglobin levels. Below are the recommended doses of the active ingredient in relation to the child's hemoglobin:
- 8 g of hemoglobin: 275.0 mg of sodium thiosulfate for each kg of body weight;
- 10 g of hemoglobin: 337.5 mg of sodium thiosulfate for each kg of body weight;
- 12 g of hemoglobin: 412.5 mg of sodium thiosulfate for each kg of body weight;
- 14 g of hemoglobin: 487.5 mg of sodium thiosulfate for each kg of body weight.
Also with regard to pediatric use, it is possible to administer sodium thiosulfate simultaneously with a hydroxocobalamin solution, but through a different administration site and at a dosage of 50-100 mg / kg suitably diluted.
If necessary, in the event of any relapse from poisoning, the administration of sodium thiosulfate and hydroxocobalamin can be repeated.
Prevention of Cisplatin Nephropathy
The recommended dose in adult patients is 9 g per m² body surface area as a bolus, followed by a continuous (6 hour) intravenous infusion of 1.2 g / m² per hour.
Desensitization in Extravasation of Chemotherapy Medicinal Products
In these cases, the patient will be injected directly into the extravasation site with a solution containing 400 mg / 10 ml (corresponding to 4 ml of sodium thiosulfate 1 g / 10 ml solution) added to 6 ml of water for injections.
only if the doctor deems it absolutely necessary, only under his strict control and only after a "careful evaluation of the relationship between the expected benefits for the mother and the risks for the fetus or infant.
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