Inorganic Arsenic Toxicosis Flashcards by Jen Whitmore

Has the use or arsenic increased or declined?

Declined

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What are 5 potential sources of arsenic?

Wood preservative
Insecticides
Herbicides
Fungicides
Rodenticides

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How can calves be poisoned by arsenic?

Milk from poisoned cows

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What are 4 types of materials arsenic can be found in?

Paint
Pigments
Detergents
Building materials

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What are the 3 oxidative states of arsenic?

Elemental
Trivalent (arsenite)
Pentavalent (arsenate)

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What does arsenic react with?

-SH group

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What is the lethal oral dose of arsenic for most species?

1-25 mg/kg

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What are 3 types of toxicosis that have been seen with arsenic?
What is one that has not been documented?

Peracute, acute, subacute

- Chronic

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What type of animals are most susceptible to arsenic toxicosis?

Herbivores

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What is one species that can get poisoned by arsenic in ant and roach baits?

Dogs

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What are 2 species that are rarely poisoned by arsenic?

Swine

- Chickens

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Name the forms of arsenic in order from least to most toxic.

Organic
Pentavalent
Inorganic trivalent

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Where is pentavalent converted to trivalent?

Liver

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What are 3 routes of entry for arsenic?

GI tract
Intact skin
Inhalation

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Where are 6 locations where arsenic achieves higher concentrations?

Liver
Kidney
Hair
Hoof
Nail
Skin

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Does arsenic cross the BBB?

Poorly

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How is arsenic mainly excreted?

What are 6 other ways it can be excreted in small amounts?

Urine

- Feces, milk, saliva, sweat, hair, exhalation

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Can milk from poisoned cows contain toxic levels of arsenic?

Yes

What does trivalent arsenic bind to?

2-SH groups of lipoic acid

What is lipoic acid?

Essential co-factor for the enzymatic decarboxylation of keto acids

Inhibition of lipoic acid inhibits or slows what?

Glycolysis and citric acid cycle

What does pentavalent arsenic do?

Uncouples oxidative phosphorylation and may interfere with vitamins B1 and B6 metabolism

T/F: Arsenic has a local corrosive effect.

True

What type of tissues are more sensitive to arsenic toxicosis?
What are 3 examples of these?

Tissues rich in oxidative enzymes

- Intestines, liver, kidney

What type of cells are most sensitive to arsenic toxicosis?

Capillary endothelial cells

Are the following signs seen with peracute, acute or subacute arsenic toxicosis: Sudden death or severe colic, collapse and death

Peracute

Are the following signs seen with peracute, acute or subacute arsenic toxicosis: Rapid onset, severe colic, staggering, salivation, vomiting, thirst, watery diarrhea which may be hemorrhagic, possible hematuria, and death in 1-3 days

Acute

Are the following signs seen with peracute, acute or subacute arsenic toxicosis: Colic, anorexia, depression, diarrhea with blood or mucosal shreds, dehydration, partial paralysis of hind limbs, and death in several days

Subacute

GI mucosal edema and hemorrhage with sloughing and perforation, liver and kidney damage can be seen with what type of toxicosis?

Arsenic toxicosis

What can be seen microscopically with arsenic toxicosis?

Capillary degeneration

Skin exposure to arsenic can cause what in addition to systemic signs?

Skin lesions and blistering

What is the best antemortem specimen for chemical analysis for arsenic toxicosis? Best 2 postmortem specimens?

- Urine | - Liver and kidney

What is the normal tissue residue level of arsenic?

0.5 ppm

What level of arsenic in the liver or kidney gives a strong indication of arsenic toxicosis?

7-10 ppm

Is there an increase or decrease in PCV with arsenic toxicosis? BUN?

- Increase PCV | - Increase BUN

Signs of sudden onset of bloody diarrhea or watery diarrhea with mucosal shreds can be seen with what type of toxicosis?

Arsenic toxicosis

Caustics, irritant plants, urea, pesticides, severe acute heavy metal toxicosis, monensin, blister beetles in horses, OP, hypomagnesemia and enteric bacterial and viral diseases are differential diagnoses for what toxicosis?

Arsenic poisoning

What type of treatment is given with arsenic toxicosis?

Emergency and supportive treatment

What are 4 forms of decontamination that can be used with arsenic toxicosis?

- Gastric lavage - Mineral oil - Activated charcoal - Demulcents to coat GI mucosa

What is contraindicated in the decontamination of arsenic toxicosis?

Emetics and strong cathartics

What is the chelator of choice for inorganic arsenic toxicosis?

Dimercaprol

What is important with the use of dimercaprol? | Why?

- Following dosage and dosage regimen | - May increase toxicity by mobilization of arsenic with wrong dose and cause toxic side effects

What is a drug that is safer but less effective than dimercaprol in severe toxicosis?

Dimercaptosuccinic acid

What is the prognosis for arsenic toxicosis?

Grave if not treated early