(acquired) Acquired unreviewed
Cyanide / carbon monoxide poisoning
Enzyme or protein defect
Complex IV (cytochrome c oxidase) inhibition
Accumulates or becomes deficient
Lactate; high venous O2 (cyanide)
Key features
Headache, coma, lactic acidosis; cherry-red skin in CO; bitter-almond odour in cyanide
Management
Hydroxocobalamin/nitrites + thiosulfate; 100% O2 or hyperbaric for CO
Not clinical guidance. Written from standard clinical biochemistry, not from the uploaded documents, and marked unreviewed. Teaching-level reference for study and database seeding only. It must not be used to manage a patient.
Recent literature
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