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4-Dimethylaminophenol

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Critical Care Toxicology

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Abstract

In normal intermediary metabolism, six adenosine triphosphates (ATPs) are created by passing two pairs of electrons down the respiratory chain from two reduced nicotinamide adenine dinucleotides to molecular oxygen. In the course of this mitochondrial ATP synthesis, the iron in cytochrome aa 3, the terminal oxidative respiratory enzyme, is oxidized from the ferrous (Fe2+) to the ferric (Fe3+) form. Cyanide has a special affinity for the ferric heme, blocking oxygen consumption and oxidative phosphorylation. Blood contains a great quantity of ferrous heme within hemoglobin that can be converted to the ferric form (methemoglobin) by the use of methemoglobin-generating agents. If methemoglobin is formed in excess of total body cytochrome aa 3, the cyanide ion binds to methemoglobin, restoring normal cellular respiration (Fig. 1).

Dr. Zilker and Dr. Eyer are retired.

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Author information

Authors and Affiliations

  1. Toxicology, Technical University Munich, Munich, Germany

    Thomas Zilker

  2. Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University, Munich, Germany

    Peter Eyer

Authors
  1. Thomas Zilker
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  2. Peter Eyer
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Corresponding authors

Correspondence to Thomas Zilker or Peter Eyer .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I.

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1.

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2.

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3.

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III.

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Zilker, T., Eyer, P. (2016). 4-Dimethylaminophenol. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_181-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_181-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-20790-2

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