Inorganic arsenic toxicosis Flashcards

1
Q

Sources

A
  • ant and cockroach bait (ewwww)
  • wood preservatives
  • insecticides, herbicides, yada yada
  • pastures near smelters
  • pass to baby cow in milk
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2
Q

What are the three states

A
  • elemental
  • trivalent (arsenite)
  • pentavalent (arsenate)
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3
Q

What does arsenic react with

A
  • SH
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4
Q

Toxicity

A

everything except chronic

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5
Q

Susceptibility

A
  • Most = herbivores
  • dogs eat it
  • swine and chickens = rare
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6
Q

Which is most toxic

A

Inorganic trivalent

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7
Q

Which is middle toxic

A

Pentavalent

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8
Q

Which is least toxic

A

organic

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9
Q

Pentavalent can be converted to

A

trivalent when in liver

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10
Q

Toxicokinetics

A
  • absorbed from GI, intact skin, inhalation
  • high distribution
  • poorly crosses BBB
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11
Q

Where is inorganic arsenic excreted

A
  • urine (within 48 hrs)

- feces, milk, saliva, sweat, hair, exhalation

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12
Q

MOA

A
  • trivalent binds to lipoic acid
  • lipoic acid is needed for glycolysis and TCA
  • interferes with vitamin B metabolism
  • locally corrosive
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13
Q

Which tissues are most sensitive

A
  • capillary endothelial cells are the most sens.

- those with the most oxidative enzymes - aka intestines, liver, kidneys

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14
Q

Peracute clinical signs

A
  • sudden death, severe colic, collapse
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15
Q

Acute signs

A
  • rapid onset
  • severe colic, staggering, slivation, vomiting, thirst, diarrhea +/- hemorrhagic, hematuria
  • death in 1-3 days
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16
Q

Subacute signs

A
  • colic, anorexia, depression
  • diarrhea with blood
  • dehydration
  • partial paralysis of hind limbs
  • death in several days
17
Q

Lesions

A
  • GI mucosal edema and hemorrhage with perforation
  • liver and kidney damage
  • capillary degeneration
  • skin lesions
18
Q

Chemical tests

A
  • Urine is best specimen when alive

- liver and kidney is best when dead

19
Q

Lab results

A
  • Increased PCV

- Increased BUN

20
Q

Treatment

A
  • Fluids and electrolytes
  • possibly blood transfusion
  • treatment of acidosis
  • vitamins, antibiotics, analgesics, dopamine
21
Q

Decontamination

A
  • Gastric lavage= ONLY if early
  • mineral oil
  • activated charcoal
  • Demulcents
22
Q

What is contraindicated in decontamination!

A
  • Emetics and strong cathartics
23
Q

Chelation therapy

A
  • Dimercaprol
  • BAL
  • chelator of choice but not 100% effective
  • has toxic side effects
24
Q

Dimercaptosuccinic acid (DMSA)

A
  • Water soluble analog of BAL

- Safer but less effective

25
Q

Prognosis

A

Grave if not treated early