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Pharmacology > Unit 6-Chelation > Flashcards

Unit 6-Chelation Flashcards

1
Q

British Anti-Lewisite

Drug class

A

Dithiol

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2
Q

British Anti-Lewisite

Mechanism

A

Forms stable chelate via electron pair donation and coordination with metal ion; solubilized in peanut oil

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3
Q

British Anti-Lewisite

Uses

A

Arsenic, lead, inorganic mercury poisoning

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4
Q

British Anti-Lewisite

Side effects

A

Renal toxicity (unless urine is alkalinized, due to dissociation)
Pain at injection site (IM); nausea, vomiting; increases in BP and HR
Given IV or IM; allergic implications (peanut oil); need to start using ASAP

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5
Q

2,3-dimercaptosuccinic acid (Succimer)

Drug class

A

Dithiol

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6
Q

2,3-dimercaptosuccinic acid (Succimer)

Mechanism

A

Coordinate bonding to sulfur (arsenic and mercury) or sulfur and oxygen (lead and cadmium)

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7
Q

2,3-dimercaptosuccinic acid (Succimer)

Uses

A

Arsenic, lead, mercury, cadmium poisoning

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8
Q

2,3-dimercaptosuccinic acid (Succimer)

Side effects

A

Mild ALT/AST elevation (usually only 2 - 3 times upper limit normal, and transient
Well tolerated; nausea, vomiting, flatuus, diarrhea
Given orally only in US;given IV in other countries with more severe adverse events secondary to IV administration

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9
Q

Edetate calcium disodium (EDTA)

Mechanism

A

Displacement of calcium by lead

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10
Q

Edetate calcium disodium (EDTA)

Uses

A

Lead poisoning

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11
Q

Edetate calcium disodium (EDTA)

Side effects

A 
Malaise, fever
Renal toxicity (proximal tubules, distal tubules, glomeruli); ALT/AST increase
Given IV; DO NOT CONFUSE WITH Na2EDTA (can lead to life-threatening hypocalcemia); if given in lead encephalopathy, there is a potential to cause lead redistribution into the brain; BAL must be given before this in that scenario
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12
Q

Ferric hexacyanoferrate /Prussian Blue (Radiogardase)

Mechanism

A

Stays in gut and not absorbed until it grabs metal; goes into gut and is excreted that way

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13
Q

Ferric hexacyanoferrate /Prussian Blue (Radiogardase)

Uses

A

Thallium and radioactive cesium poisoning

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14
Q

Ferric hexacyanoferrate /Prussian Blue (Radiogardase)

Side effects

A

Well tolerated; not absorbed after oral dosing into systemic circulation (this is pretty unique)
Some concern that cyanide is liberated from Prussian Blue, however the amount released appears to be quantitatively minimal & not clinically significant

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15
Q

Deferoxamine (Desferal)

Mechanism

A

Chelates free iron and iron transported between transferrin and ferritin

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16
Q

Deferoxamine (Desferal)

Uses

A

Acute iron poisoning; chronic iron overload

17
Q

Deferoxamine (Desferal)

Side effects

A

Rate-related hypotension; anaphylactoid reactions; yersinia enterocolitis; acute lung injury/ARDS
Can only treat for 24 hours before acute lung injury manifests

Pharmacology (26 decks)

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