New antidote for cyanide can quickly save victims of a terrorist attack or industrial accident.

I’ve got three good friends who work for Homeland Security and two other federal agencies. All earn their government-green paychecks trying to protect the citizenry from the worst that terrorists, extremists or saboteurs can inflict upon us.

Studying all the ways to quickly kill a lot of people takes its toll on those who anguish over defending the innocent from all the lethal agents from which to choose. They tell me that it’s not just the new designs for weapons of mass destruction – like dirty bombs or nanotech delivery systems – that steal their sleep. Methods centuries old still worry them greatly.

An FBI WMD response team

Take cyanide for example, a naturally occurring chemical first identified as a poison in 1782.

In 1870, during the Franco-Prussian War, Napoleon urged his troops to dip their bayonet tips in cyanide before battle.

Hydrogen cyanide gas poisoned World War I battlefields, and in the next war was used to kill millions in Nazi death camps.

A library can be filled with novels where “the scent of bitter almond” led Agatha Christie and other murder mystery writers to conclude that a death was not from natural causes.

In Jonestown, Guyana, in 1978, cyanide was the poison used in history’s largest documented mass suicide, when cyanide-tainted, purple Kool-Aid was given to 909 members of Jim Jones’ People’s Temple.

In May 1995, the Japanese religious cult Aum Shinrikyo was thwarted in its attempt to detonate cyanide gas-generating devices in Tokyo’s busiest subway system.  Terrorism experts estimated that 20,000 commuters could have been killed if the generators had not been found. Two months earlier, the same group released Sarin gas in 15 Tokyo subway stations, sickening 3,800 and killing 12.

Today, at mines throughout the world, gold hungry companies use a mist of cyanide to draw the precious metal out of low-grade ore. And at mine sites in Montana, Canada, South America and Africa, many of those living nearby are slowly sickened and disabled by cyanide contaminating drinking water.

Cyanide is always near the top of terrorism-fighter’s hate lists because it’s easy to acquire and hard to protect against.

Cyanide causes a coma when inhaled, quickly followed by seizures, breathing failure and cardiac arrest. It can kill quickly.

Homeland Security and FEMA have distributed tens of thousands of cyanide antidote kits to hospitals and ambulances nationwide and thousands of other kits are stockpiled throughout the country.

The three drug components in the kit, given soon enough, can save a life. But administration of the drugs is complex and cumbersome. First, fumes from a crushed inhalant of pearls of amyl nitrite must be inhaled by the victims. Then two other drugs, sodium thiosulfate and sodium nitrite, must be given rapidly by intravenous infusion.

One of the old style cyanide antidote kits on the market

Emergency response authorities have long said that in a mass casualty event with hundreds of victims from a massive fire, or industrial or terrorist release of cyanide, the old kits are far from adequate.

But there may be something new for the first responder to use to save those exposed to the fast-acting poison.

Steven Patterson and his colleagues at the University of Minnesota Center for Drug Design announced in a study, “Cyanide Antidotes for Mass Casualties,” published in the ACS’s Journal of Medicinal Chemistry, that they may have the answer to defending against mass injury cyanide attacks.

The journal article says that under the old treatment system, “only a limited number of victims could be saved’’ because of the complexity of the treatment.

“Accordingly, it was incumbent on us to devise much more rapid delivery methods for the treatment of mass casualties, perhaps also aided by deployment of rapid action mechanical devices,” the scientists wrote.

Using sulfanegen triethanolamine, they developed a cyanide antidote that could be quickly and easily administered, in one step, by intra-muscular (IM) injection with an auto-injector, pen-like device. These are commonly used to administer insulin, epinephrine, atropine other emergency medication.

Not only could large numbers of people be treated quickly, the antidote could even be self-administered.

The Minnesota group is undertaking further animal testing at various cyanide levels, and emergency planners tell me they wish them all speed.

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