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Pharmacology toxicology and prescription > Chelators > Flashcards

Chelators Flashcards

1
Q

List the chelators

A
  • Dimercaprol
  • Succimer, DMPS
  • Penicillamine
  • Trientine
  • EDTA calcium disodium
  • Deferoxamine
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2
Q

Pharmacokinetics of dimercaprol

A
  • Not stabile in water, dispensed in peanut oil
  • Always given IM!!!
  • Good permeability, binds intracellular located cations (advantage/disadvantage)
  • Excretion by kidney (6-8 hours)
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3
Q

Indications of dimercaprol

A
  • Acute arsenic, inorganic mercury, gold, bismuth, antimony intoxication
  • Severe lead intoxication (combined wit NaCaEDTA)
  • Special: encephalopathy due to inorganic lead or bismuth
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4
Q

Adverse effects and contraindications of dimercaprol

A

Adverse effects:

  • Nausea, vomiting
  • HTN
  • Tachycardia
  • Fever
  • Pain
  • Hematoma at injection site (thrombocytopenia, increased prothrombin time)

Contraindication:

  • Cadmium and methyl-Hg intoxication
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5
Q

Pharmacokinetics of Succimer, DMPS

A
  • Water soluble forms of dimercaprol
  • Oral (DMPS also parenteral)
  • Moderate intracellular distribution/less adverse effects
  • Faster excretion
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6
Q

Indications of Succimer, DMPS

A
  • Acute arsenic and mercury intoxication (only effective for some hours after intoxication)
  • Lead poisoning (but no encephalopathy)
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7
Q

Adverse effects of Succimer, DMPS

A
  • Better tolerated than dimercaprol
  • Nausea, vomiting
  • Diarrhea
  • Mild/moderate neutropenia
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8
Q

Indication and adverse effects of penicillinamine

A

Water soluble derivative of penicillin, orally administered

Indications:

  • Copper intoxication (wilson’s disease)
  • RA

Adverse effects:

  • Hypersensitivity reactions
  • Autoimmune reaction (long-term treatment)
  • Vitamin B6 depletion
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9
Q

Indications of trientine

A
  • Copper intoxication (wilson’s disease)
    • In cas of penicillamine allergy
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10
Q

Pharmacokinetics of EDTA calcium disodium

A
  • ø absorption from GI ==> slow IV infusion administration
  • Distribution only in extracellular compartment
  • Fast excretion by kidney (glomerular filtration)
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11
Q

Indications and averse effects of EDTA calcium disodium

A

Indications:

  • Lead poisoning (binds other cations too)

Adverse effects:

  • Nephrotoxicity (rarely)
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12
Q

Pharmacokinetics of deferoxamine

A
  • ø absorption from GI ==> IV or IM administration
  • Excretion by kidneys and partly bile
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13
Q

Indications of deferoxamine

A
  • Iron poisoning
  • Hemosiderosis, thalassemia
  • Aluminum toxicity in kidney failure
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14
Q

Adverse effects of deferoxamine

A
  • Idiosyncratic reactions
  • ARDS
  • Neurotoxicity
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Pharmacology toxicology and prescription (20 decks)

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