What is the adult dose and route for Hydroxocobalamin in cyanide exposure?

• A. 2 g IV/IM over 5 minutes
• B. 1 g IV push
• C. 5 g IV/IO over 15 minutes
• D. 10 g IV over 30 minutes

Answer: (C)

Hydroxocobalamin works by binding cyanide to form cyanocobalamin, which is then safely excreted. For adults with cyanide exposure, the standard regimen is 5 grams given intravenously over about 15 minutes, and it can be administered via IV or intraosseous access if IV isn't available. This dose provides sufficient binding capacity to neutralize the cyanide load encountered in many exposure scenarios.

The other options are not aligned with typical dosing guidelines: a smaller amount would likely be insufficient to sequester cyanide quickly enough, while a much larger dose is not the standard recommendation in most protocols.