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KAT PHR 57

Heavy metal

QuestionAnswer
Most heavy metal toxicities occur due to interaction with sulfhydryl groups
Chelators are compound with _ electronegative groups’ 2 or more
Chelators function as _ chemical antagonists
Acute lead poising typically affects which system CNS
Acute lead poising treated with chelation
Chronic lead poisoning treated with succimer, EDTA, dimercaprol
Acute arsenic poisoning affects mostly GI
Chronic arsenic poisoning affects everything, carcinogenic
Arsenic gas affects mostly renal system
Acute arsenic poisoning treated with supportive and dimercaprol
Chronic arsenic poisoning treated with dimercaprol
Arsenic gas treatment supportive
Acute mercury poisoning causes SOB, nausea, vomiting
Mercuric chloride causes renal failure, hemorrhagic gastroenteritis
Acute mercury tox treated with succimer, dimercaprol (IM)
Chronic mercury poising causes erethism (behavioral change)
Chronic mercury poising treated with succimer, Unithiol
Avoid _ in treating chronic mercury poising dimercaprol, redistributes to CNS
Iron tox symptoms GI, jaundice, coma
Treat Fe tox with deferoxamine
EDTA used for_ detox Lead
Dimercaprol used for arsenic, mercury and with EDTA for lead
Dimercaprol side effects lipophilic, thrombocytopenia, increased prothrombin time
Succimer used for lead, arsenic ( within a few hours of exposure) and mercury ( within a few hours of exposure)
Succimer side effects less than dimercaprol, liver enzymes, rash, GI
Unithiol is a water soluble dimercaprol
Unithiol used for inorganic mercury or arsenic
Penicillamine is used for copper excess
Penicillamine excretion water soluble, absorbed from GI, excreted unchanged
Penicillamine tox neprhotox, pancytopenia, autoimmune, hemolysis
EDTA used for lead poisoning
EDTA administered with calcium
EDTA tox tubular necrosis and ECG changes
Deferoxamine, deferasirox used for Fe
Deferoxamine, deferasirox tox skin rxn, hepatic and renal dsfx, coagulopathy
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