全身中毒性毒剂.pptx

Chapter 4 Systemic agents (Cyanides)全身中毒性毒剂 (氰化物)Zyklon BAuschwitz campContentsIntroductionRepresentativesPhysicochemical characteristicsToxicityMetabolismMechanism of toxicityClinical effectsDiagnosis and differential diagnosisAntidotes and mechanismMedical management1. Introduction全身中毒性毒剂(systemic agents)是以氢氰酸(HCN)和氯化氰(ClCN)为代表的一类暂时性毒剂，这类毒剂主要通过呼吸道中毒，破坏机体组织细胞的生理氧化，引起组织细胞不能利用O2，产生组织缺O2，从而导致一系列全身中毒症状的出现。由于其分子结构中含有氰根(CN-)，故亦称为氰类毒剂(cyanides). 1.2 History/Military RelevanceHydrogen cyanide: first isolated from a blue dye (Prussian blue) in pure form in 1782 by the Swedish chemist Carl W. Scheele, and was eventually given the German name Blaus?ure (literally Blue acid). In English, popularly as Prussic acid.Cyanogen chloride: discovered by Wurtz and first prepared by Berthollet in 1802. Ancient Egypt and RomePlayfair (an English) advocated the use in Crimean warNapoleon III proposed use in Franco-Prussian warWWI: French used 4000 tons of cyanide, BritainU.S. maintained a small number of munitions in WWII Japan: against China before and during WWIIIraq used cyanide against the Kurds in the 1980sNazi Germany: Zyklon B in Auschwitz camp In WWII (6,000 each day, totally 6,000,000 claimed)Interior of Majdanek gas chamber, showing Prussian blue residue1.3 Sources other than military Ubiquitous in nearly all living organismsWidely used in industryCombustion products of many materials Ubiquitous in nearly all living organisms:很多果实与种子(特别是瘢痕中)，例如 樱桃、桃子、杏、利马豆等含有氰类物质(cyanogens)，在酶解之后能够产生自由状态的氰化物。 100g almond→100~250mg HCN Ubiquitous in nearly all living organisms:东南亚一带的粮食作物之一木薯(cassava) 亦可产生氰化物。 有一些昆虫(millipedes)可以释放氢氰酸来防卫。有人认为可能跟生命起源有关 (最近在太空星云中发现)。Philippines cassava incident—March 9, 200530 kids died,103 hospitalized白色品种氰化物含量可达330~360 ppm，黄色品种 30~60 ppm. 人体最大可耐受量120 ppm1.3 Sources other than military ? Ubiquitous in nearly all living organisms? Widely used in industry? Combustion products of many materialsIndustrial concerns in the U.S. manufacture thousands of tons of hydrog