Non-Essential Trace Ions

• Freon

• Teflon

Calcium Hydroxyapatite, Ca10(P04)6(OH)2

Major component of bones and teeth is

Fluorine

• Skeletal fluorosis

• Dental fluorosis

Chronic exposure to high fluorine may cause:

Sodium Fluoride

Sodium Monofluorophosphate (Na2PO3F)

Stannous Fluoride

Bromide

Bromide

When handling bromine, it is always advisable to have ammonia water within reach to stop its action (deep red brown color)

Bromine T.S. (Bromine Water)

Saturated solution of bromine prepared by agitating from 2-3 mL of bromine with 100 mL of cold distilled water in glass-stoppered bottle (coated with petrolatum)

Bromine, Tenth Normal (Koppeschaar’s Solution)

Solution of potassium bromate (3mg) and potassium bromide (15mg) in water sufficient to make a liter.

• + chlorine TS = red to brownish color

• + AgnO3 TS = yellow-white ppt

Officia I'd test for bromine

• Bromism (bromide intoxication, bromide acne)

• Bromide psychosis

Bromide toxicity:

NaCl

Bromide acne treatment

Potassium Bromide (KBr)

Lithium

Na2CO3 (alkalinized wth NaOH) → white ppt

Official ID test for lithium

Lithium

Solutions of what salts are not precipitated by sulfuric acid or soluble sulfates (distinction from strontium)?

Lithium

• Now recognized as a “Mood-Stabilizing Agent”

• Used in mania and bipolar manic--‐depressive illness.

• Precise mechanism of action is still unknown.

0.9-1.1

Lithium ha sa very narrow TI:

• 0.6-1.25 meq/L: Generally accepted safe range

• — meq/L: Target range for manic or hypomanic states

Lithium bromide

What lithium compound is Used as sedative because of the central depressant properties of bromide ion?

• Lithium Carbonate (Quilonium)

• Lithium Citrate

• Lithium Hydroxide

• Lithium Bromide (Non-official)

Official Lithium Compounds

Rheumatoid Arthritis

Chronic inflammatory disease characterized by the migration of activated phagocytes and leukocytes into synovial tissue, which causes progressive destruction of cartilage bone and joint swelling.

Aurosomes

Gold accumulates in the lysosomes of synovial cells and macrophages, forming gold laden deposits known as

Gold Sodium Thiosulfate Na2Au(S2O3)2.H2O

IM treatment for nondisseminated lupus erythematosus and rheumatoid arthritis

Auranofin

Aurothioglycanilide

Aurothioglucose

Gold Sodium Thiomalate

Chronic poisoning

Arsenic

Uses of this elements

• Anti lekemic

• Polycythemia vera

• Antipotozoal infection (syphilis)

Arsenic Trioxide in water with NaOH and dil. HCl to adjust pH (7.5-8.5)

Trisenox ® preparation:

Potassium Arsenite Solution (Fowler’s Solution)

Gutzeit test

Specific Test for Arsenic that yields orange yellow stain

• Metallic

• Amorphous (explosive)

• Black

• Yellow

Stibium allotropes:

Antimony

• Stibophen

• Antimony potassium tartrate (Tartar emetic)

• Antimony sodium thioglycollate

• Antimony thioglycollamide

Organic Compounds of Sb

Antimony

Barium

Barium sulfate

This barium compound is used as a diagnostic agent but can be mistakenly prescribed as barium sulfide or barium sulfite.

Cadmium

Chemically, it reacts with hydrogen sulfide, forming a bright yellow sulfide.

Cadmium

Itai-Itai Disease: The Ouch-ouch disease

Symptoms are osteomalacia, osteoporosis and renal failure. It is the toxicity of cadmium

PbS (Galena)

most important and widely distributed principal lead ore

Pica

What is one of the worst risk factors for lead poisoning

• BAL Dimercaprol

• Calcium disodium estate (EDTA)

Treatment for lead poisoning

Liquor Plumbi Subacetatis or Goulard’s Extract

Lead Subacetate Solution [(Pb2O(CH3COO)2] other name

Liquor Plumbi Subacetatis Dilutus or Lead Water

Diluted Lead Subacetate Solution (Official) other name

Litharge

Lead Monoxide (PbO) other name

Hg (Quicksilver, liquid silver)

Can be obtained from HgS or Cinnabar (Crystalline red)

• Inhalational: easily absorbed; can cross BBB

• Dermal: minimal absorption

• Placental: can accumulate in the fetus

• Oral: minimal absorption

Elemental ercury exposure pathways

Organic mercury

What form of mercury is used as a fungicide

• Oral: completely absorbed due to lipid solubility

• CNS: easily crosses

• BBB– Placenta and Breast Milk: easily crosses placenta and accumulates in breast milk

Organic mercury exposure pathways

• +1N NaOH → Yellow ppt

• +KI → Scarlet ppt

Mercuric salts ID test

• +NaOH → Black color

• +HCl → white ppt to black

• +KI → yellow to green ppt

Mercurous salts ID test

• Mercurous chloride

• Ammoniated mercury ointment (blue ointment)

What mercury compound has:

• Antisyphilic action

• Parasiticidal and fungicidal action

• Egg albumin

• Dimercaprol

• Gastric lavage

• Best antidote: sodium formaldehyde sylfoxylate

Mercury antidotes

Minamata Disease

Corrosive sublimate

HgCl2 other name

Yellow precipitate

Mercuric oxide other name

Mercurous chloride (calomel)

Mercury compound used as a cathartic and prophylaxis for syphilis

Silver Nitrate (AgNO3)

• Lapis infernalis

• Lunar caustic

• Caustic pencil

AgNO3 other name

Silver sulfadiazine (Flammazine®)

Silver compounds as tx of burns (germicidal)

Recall

Recall