7. Arsenic poisoning

Question 1

What are the sources of arsenic poisoning?

Answer 1

Widely used in industrial processes, manufacture of:

1. semiconductors
2. wood preservatives
3. glass
4. herbicides
5. released during the burning of coal,
6. “magic bullet” for syphilis – first pharmaceutical antimicrobials.

Question 2

What is Pharmacodynamics/MOA of arsenic?

Answer 2

Inhibition of enzymes via sulfhydryl binding.

Question 3

What are the symptoms of chronic arsenic poisoning?

Answer 3

1. skin changes (stocking-glove pattern)
2. hair loss
3. bone marrow depression, anemia
4. chronic nausea and gastrointestinal disturbances
5. carcinogen.

Question 4

What is the major route of absorption of arsenic?

Answer 4

Respiratory and GI tract

Question 5

What are the symptoms of acute arsenic poisoning?

Answer 5

• Severe gastrointestinal discomfort
• vomiting
• “rice-water” stools
• capillary damage - dehydration and shock.

Question 6

??

Answer 6

Arsine gas industry (manufacture of semiconductors) Causes massive hemolysis – Pigment overload from erythrocyte breakdown can cause renal failure. Treatment is supportive - exchange transfusion, vigorous hydration.

Question 7

How is the metabolism and elimination of arsenic in the body?

Answer 7

Metabolism: methylation, mainly in the liver.

Elimination: via kidney

Question 8

How do you treat chronic arsenic poisoning?

Answer 8

Dimercaprol therapy appears to be of value.

Question 9

How do you treat acute arsenic poisoning?

Answer 9

Replace water, electrolytes, and chelation therapy with dimercaprol