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
2
Q
What are the three states
A
- elemental
- trivalent (arsenite)
- pentavalent (arsenate)
3
Q
What does arsenic react with
A
- SH
4
Q
Toxicity
A
everything except chronic
5
Q
Susceptibility
A
- Most = herbivores
- dogs eat it
- swine and chickens = rare
6
Q
Which is most toxic
A
Inorganic trivalent
7
Q
Which is middle toxic
A
Pentavalent
8
Q
Which is least toxic
A
organic
9
Q
Pentavalent can be converted to
A
trivalent when in liver
10
Q
Toxicokinetics
A
- absorbed from GI, intact skin, inhalation
- high distribution
- poorly crosses BBB
11
Q
Where is inorganic arsenic excreted
A
- urine (within 48 hrs)
- feces, milk, saliva, sweat, hair, exhalation
12
Q
MOA
A
- trivalent binds to lipoic acid
- lipoic acid is needed for glycolysis and TCA
- interferes with vitamin B metabolism
- locally corrosive
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
14
Q
Peracute clinical signs
A
- sudden death, severe colic, collapse
15
Q
Acute signs
A
- rapid onset
- severe colic, staggering, slivation, vomiting, thirst, diarrhea +/- hemorrhagic, hematuria
- death in 1-3 days
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
Prognosis
Grave if not treated early
