Amygdalin, a cyanogenic glycoside, is metabolized by the enzyme iulsin to hydrocyanic acid. In sufficient quantities, hydrocyanic acid may lead to acute cyanide toxicity. The requisite enzyme (iulsin) is present in the pits or seeds listed above and may be present to some degree in intestinal bacteria. Ingestion of large amounts of seeds or pits results in diaphoresis, nausea, vomiting, abdominal pain, and lethargy. Symptoms develop over hours. GI decontamination is needed. If symptomatic, antidotal therapy may be needed for cyanide toxicity (amyl nitrate, sodium nitrate, and sodium triosulfate). See ChapterJ 82, "Cyanide," for further discussion.
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