Chronic Lead poisoning Flashcards
What are GI issues
colic, abdominal pain, constipation
CNS issues
children - hyperirritability, loss of recently acquired skills, persistent vomiting, coma, convulsions. Adults - fewer side effects
NM issues
Weakness, paralysis, wrist drop, arthlagia
Blood
Hypochromic microcytic anemia, basophilic stipling in RBCs due to RNA aggregates
What is the mechanism of poisoning with lead
Inhibits conversion of delta-ALA into porphobilinogen. Blocks incorporation of Fe into protoporphyrin IX.
What are the lab values with Lead poisoning?
Increased Urine ALA, decreased hematocrit, increased reticulocytes, High Blood and Urine lead levels
What does the blood smear look like with lead poisoning?
hypochromic, microcytic anemia
How do you treat lead poisoning?
remove form exposure, dimercaprol EDTA for 2-7 days, penicilliamine for long term. Give milk, the calcium competes for absorption with lead.
What are the chelators?
Dmiercaprol, D-penicillinamine, Succimer/dimercaptosuccinic acid, unithiol
What is Dimercaprol used to treat?
acute Leab, arsenic and inorganic mercury. SE are CNS tremors, N/V, convulsions. CI: Iron exposure, hypertensive patients
What is D-penicillamine used to treat?
Lead, mercury, copper poisoning. Se: nephrotic syndrome, blood dyscrasias. CI in patients with penicillin allergy
What is succimer, aka demercaptosuccinic acid used to treat?
High selectivity for lead, produced lead diuresis. SE: N/V/D/anorexia
What is unithol/dimercaptopropanesulfonic acid used to treat>
mercury, arsenic and lead toxicity.
