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b. mercury poisoning
Minamata Disease refers to
a. copper toxicity
b. mercury poisoning
c. manganese toxicity
d. aluminum toxicity
c. iron
Deferoxamine is most useful in the treatment of poisoning caused by:
a. arsenic
b. mercury
c. iron
d. lead
d. both a & b
Pinicillamine use
a. tx of rheumatoid arthritis
b. treatment of copper toxicity
c. tx of g(+) infections
d. both a & b
d. iron; cd ; Se
BAL is used in chelating the ff heavy metals, except
a. arsenic
b. mercury
c. lead
d. iron; cd ; Se
a. Zinc poisoning
Metal Fume fever
a. Zinc poisoning
b. Iron poisoning
c. Cadmium poisoning
d. Mercury poisoning
a. Manganese
Parkinson like symptoms
a. Manganese
b. magnesium
c. Aluminum
d. Zinc
a. Aluminum Toxicity
Shaver’s disease
a. Aluminum Toxicity
b. Mercury Toxicity
c. Cadmium toxicity
d. Chromium toxicity
Lead
Sources: *Paint, Old Pipes, Lead Contaminated, Soil & Dust (Old Building), Jewelry & Toys, Drinking Water
Plumbism or Saturnism (Archaic)
Lead Poisoning:
Acute Lead Poisoning
Children – acute abdominal colic and CNS change
Chronic Lead Poisoning
Plumbism
Result of gradual accumulation
Peripheral neuropathy (wrist drop)
Anorexia
Anemia
Weight Loss, Tremor
Oral Succimer (children)
Antidote for Mild Lead Poisoning
EDTA & (+) BAL (if encephalitis is present)
Antidote for Severe Lead Poisoning
Cadmium
Sources: Smokes and “Stink Bomb”
Itai-Itai
Toxicity of Cadmium:
EDTA (+glutathione)
BAL IS NOT RECOMMENDED
Treatment for Cadmium Toxicity
Elemental Hg
Amalgam
HgCl (calomel)
HgCl2 (corrosive sublimate)
Inorganic forms for Mercury Toxicity
Alkyl Mercury (Methyl Hg)
Thimerosal (old antiseptic | NEW: Benzalkonium
organic forms for Mercury Toxicity
Minamata Disease – acute alkyl mercury toxicity (methyl mercury)
Erethism – aka Mad Hatter Disease | affects the neurological & behavioural of the px
Acrodymia – aka Pink Disease | In children: pink & painful extremities (palms & toe)
Toxicity of Mercury:
Minamata Disease
acute alkyl mercury toxicity (methyl mercury)
Erethism
aka Mad Hatter Disease
affects the neurological & behavioural of the px
Acrodymia
aka Pink Disease
In children: pink & painful extremities (palms & toe)
NOT recommended for BAL – it may redistribute mercury in the CNS
Na Formaldehyde Sulfoxylate – PACOP; antidote
Treatment for Mercury Toxicity
Lewsite Metal
Arsenic is also known as
Arsenic
KING OF ALL POISONS – colorless, odourless, tasteless
SAVIOR OF SYPHILIS – Salvarsan, Compound606, Arsphenamine ~ 1st effect treatment of syphilis
colorless
odourless
tasteless
Arsenic is called the king of all poisons because of its characteristics:
Salvarsan,
Compound 606,
Arsphenamine
1st effect treatment of syphilis:
Melarsoprol – African sleeping sickness
Paris Queen – copper acetoarsenite
Fowler’s Solution – K arsenite
Arsphenamine –
(+) heat or acid → AsH3 (Arsine Gas) = highly irritating, massive hemolysis, renal failure
Arsenic is present in:
Arsine gas
when arsenic is reacted w/ heat or acid, it produces:
Aldrich – Mee’s Line
Garlic Odor of Breath
Luminous vomitus
Black line gums
Alopecia
Signs and symptoms of Arsenic poisoning:
BAL (Dimercaprol)
+ Penicillamine (if severe)
Treatment for Arsenic poisoning
Aluminum
3rd most abundant element & most abundant metal on Earth
Uses: Antacid, Astringent
Deferoxamine
Treatment for aluminum toxicity
Aluminosis or Shaver’s Disease
Aluminum Poisoning is called:
Zinc
Used in galvanizing iron & container for battery cells
Parakeratosis
Zinc deficiency is called:
Metal Fume Fever
Zinc toxicity is called:
Bed Rest,
NSAIDs (ASA)
Zinc toxicity treatment:
Iron acute toxicity
Lethal dose: 200-300 mg/kg
Toxic dose: >60 mg/kg
Iron chronic toxicity
Hemosiderosis: iron overload, tissue damage
Hemochromatosis – iron overload has no tissue damage
Lethal dose
ingestion of FeSO4 tablets w/ 200-300 mg/kg is considered as:
Toxic dose
ingestion of FeSO4 tablets w/ >60 mg/kg is considered as:
Hemochromatosis
iron overload, tissue damage
Hemosiderosis
iron overload, has no tissue damage
Stage 1
What stage of Iron Poisoning?
GI Phases
GI irritation
Nausea, Diarrhea, GI upset
Stage 2
What stage of Iron Poisoning?
Latent Phase
GI improvement
Stage 3
What stage of Iron Poisoning?
Metabolic & CV phase | most patients die
Cardiotoxicity
CNS problem (coma)
Stage 4
What stage of Iron Poisoning?
Hepatic phase
Liver Failure
Hypoglycemia
Stage 5
What stage of Iron Poisoning?
Delayed phase
Scarring of healing GI tract
Bowel obstruction
Deferoxamine (parenteral/IV)
Deferasirox (orally)
Antidote for Iron Poisoning
Copper
Essential trace element
IUD (intraurine device) – Copper Oil; prevent pregnancy
Copper Cookware (uncoated) + acid à leaching
Copper can be found in:
Copperiedus
*Wilson’s Disease: genetic disorder in which excess copper builds up in the body
Copper toxicity:
Wilson’s Disease
genetic disorder in which excess copper builds up in the body
Chromosome #13
Wilson’s disease gene; a transport protein that transfers copper → liver
Penicillamine
Treatment for copper toxicity
Chromium
Glucose tolerance factor
DM like
Chromium Deficiency:
Acute Chromium Ingestion Toxicity
GIT corrosion
Multiple Organ Damage
Often Fatal (regardless of therapy used)
Chronic Chromium Ingestion Toxicity
Respiratory tract irritation
Most Serious: Lung Cancer
Manganism,
Permanent neurological disorder
Parkinson’s Like
Manganese Toxicity is called:
EDTA (poor enter to the brain)
PAS (neuroprotectant)
*Levodopa (parkinson’s disease) = poor clinical response
Manganese antidotes: