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PCOL MIDTERMS > UNIT 6: HEAVY METALS AND CHELATORS > Flashcards

UNIT 6: HEAVY METALS AND CHELATORS Flashcards

1
Q

Elements with high atomic weights, densities and, atomic numbers

A

HEAVY METALS

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2
Q

Enumerate:

Microessential nutrients

A

Iron, Cobalt, Zinc

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3
Q

Enumerate:

Less Harmful Substances

A

Ruthenium, Indium

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4
Q

Enumerate:

Toxic Substances

A

Cadmium, Mercury, Lead

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5
Q

Enumerate:

These 5 have the greatest potential to cause harm especially in high amounts or doses

A
  • chromium
  • arsenic
  • cadmium
  • mercury
  • lead
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6
Q

Examples of this heavy metal are

storage batteries, ammuniton, and ceramics

A

Lead

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7
Q

Highly colored toys may contain what?

A

Lead

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8
Q

This was also used in water pipes

coining the term “plumber”

A

Lead

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9
Q

One of the oldest and most prevalent heavy metal that has been contaminating our environment

A

Lead

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10
Q

T/F:

Lead has no useful purpose in the body

A

True

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11
Q

T/F:

Lead does not cross the placenta

A

False

it crosses the placenta

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12
Q

Deferoxamine/Deferasirox/Deferiprone

FDA approved oral treatment of iron overload caused by blood transfusions

A

Deferasirox

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13
Q

Deferoxamine/Deferasirox/Deferiprone

Parenteral chelator of choice for iron poisoning

A

Deferoxamine

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14
Q

Arsenic/Lead/Mercury/All:

Torsades de pointes

A

Arsenic

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15
Q

Give the chelator or chelating agent:

Used to treat copper poisoning like Wilson’s disease

A

Penicillamine

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16
Q

Give the chelator or chelating agent:

Used for chelation of lead as well as zinc and manganese

A

Edetate Calcium Disodium or EDTA

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17
Q

increases or decreases?

For Lead, Low dietary calcium, iron deficiency and ingestion on an empty stomach _ absorption

A

increases absorption

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18
Q

T/F:

The half-life of lead in bones is 1-2 months

A

False

the half-life in bones is years to decades

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19
Q

Lead toxicity can be diagnosed in what samples? (4)

A
  • bile
  • skin
  • hair
  • nails
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20
Q

Lead in children:

It can lead to lowering of _, hearing loss, and an increase of learning disabilities

A

intelligence quotient (IQ)

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21
Q

T/F:

Lead may still affect adults’ intelligence quotient

A

False

It can lead to some neurocognitive effects but won’t affect IQ

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22
Q

What types of anemia can lead cause?

A
  • normocytic
  • microcytic
  • hypochromic
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23
Q

Most important complication of lead poisoning:

A

nervous system disorders particularly seizures

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24
Q

What are the 2 major forms of lead intoxication?

A
  • Inorganic
  • Organic
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25
Q

Inorganic/Organic

What type of lead is majorly eliminated through urine and feces?

A

Organic

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26
Q

Example of this heavy metal are:

wood preservatives, glass, MSMA

A

Arsenic

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27
Q

Groundwater may contain high amounts of what?

A

Arsenic

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28
Q

Arsenic is

metabolized via the liver via _ _

A

methylation reactions

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29
Q

Historically, used as a pharmaceutical agent but now limited in use

A

Arsenic

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30
Q

what heavy metal

causes DNA alterations

A

Arsenic

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31
Q

Distribution of arsenic is highest in what organs? (2)

A

liver & kidney

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32
Q

what heavy metal causes pancytopenia?

A

arsenic

acute arsenic poisoning

*A condition in which there is a lower-than-normal number of red and white blood cells and platelets in the blood. *

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33
Q

This heavy metal may cause dark deposits at the gingival margin

A

lead/lead sulfide

“gingival lead lines”

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34
Q

What are used to chelate lead? (3)

A
  • Intravenous EDTA (CaNa2EDTA)
  • dimercaprol
  • succimer (DMSA)
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35
Q

what heavy metal?

Months after an acute poisoning, transverse white striae (Aldrich-Mees lines) may be visible in the nails

A

Arsenic

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36
Q

Causes the raindrop pattern

A

Arsenic mixed with water

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37
Q

Used to treat acute arsenic poisoning?

A
  • Unithiol
  • Dimercaprol
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38
Q

Mercury is also called?

A

quicksilver or liquid metal

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39
Q

Chronic poisoning from inhalation of what results in a classic triad of tremor, neuropsychiatric disturbance, and gingivostomatitis?

A

mercury vapor

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40
Q

Humans are exposed to this through fluorescent lamps, dental amalgams, and artisanal gold production

A

Mercury

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41
Q

Mercury is usually mined as:

A

HgS (in cinnabar ores)

42
Q

What caused Minamata disease?

43
Q

3 forms of Mercury Intoxication

A
  • Elemental
  • Organic
  • Inorganic
44
Q

elemental/inorganic/organic mercury

major route is respiratory

45
Q

elemental/inorganic/organic mercury

causes erethism

46
Q

elemental/inorganic/organic mercury

Eliminated through the urine only

47
Q

elemental/inorganic/organic mercury

eliminated through deacylation

48
Q

An uncommon idiosyncratic reaction to subacute/chronic mercury exposure

occurs mainly in children

49
Q

Erethism is also called

A

Mad Hatter Disease

50
Q

What should never be used for elemental or organic mercury intoxication?

A

Dimercaprol

51
Q

What are used to treat mercury poisoning? (3)

A
  • Unithiol
  • Dimercaprol
  • Succimer
52
Q

The formation of the _ Complex prevents or reverses the toxic effects of heavy metals

A

Chelator-Heavy Metal Complex

53
Q

Chelators are only effective in what form?

A

Free or ionized form

54
Q

A chemical warfare agent containing arsenic

55
Q

Other name for Dimercaprol: (BAL)

A

British Anti-Lewisite

56
Q

What is used to treat lead poisoning?

increases excretion rate of lead

57
Q

Increases rate of excretion of arsenic and lead

(can also be used for inorganic mercury)

A

Dimercaprol

58
Q

Decreases mercury content in kidney

59
Q

Associated with increase in ALT, AST, mild neutropenia

60
Q

Chelates extracellular metals ions much more effectively compared to intracellular metal ions

A

Edetate Calcium Disodium (EDTA)

61
Q

Adverse effect of this chelator:

Stevens-Johnson Syndrome

62
Q

Water-soluble analogs of dimercaprol

A
  • Unithiol
  • Succimer
63
Q

Adverse effect of this chelator:

Urticaria (hives) & Erythema multiforme

A

Unithiol

basta dermatologic, unithiol :D

64
Q

White, crystalline, derivative of Penicillin

A

Penicillamine

65
Q

Also used to treat severe Rheumatoid Arthritis

A

Penicillamine

66
Q

has protective effects against mercury & arsenic

67
Q

Penicillamine is also called D_ C_

A

Dimethyl Cysteine

68
Q

This plus hemodialysis is useful in
treatment of aluminum toxicity

A

Deferoxamine

69
Q

Deferoxamine is isolated from what fungi?

A

Streptomyces pilosus

70
Q

Give the 3 Iron Chelating Agents:

A
  • Deferoxamine
  • Deferasirox
  • Deferiprone
71
Q

Deferoxamine/Deferasirox/Deferiprone

Which is not given orally?

A

Deferoxamine

given via IM or IV

73
Q

Other name for Prussian Blue

A

Ferric Hexacyanoferrate

74
Q

Indicated for treatment of contamination with radioactive Cesium and intoxication with thallium salts

A

Prussian Blue

75
Q

Are drugs used to prevent/reverse the toxic effects of a heavy metal on an enzyme

A

Chelating agents

76
Q

It may offer therapeutic benefit in the treatment of acute intoxication by arsenic, lead, and mercury.

A

Dimercaprol

77
Q

EDTA is indicated mainly for chelation of _

78
Q

What chelator has no FDA-approved indications?

79
Q

the diagnosis of lead intoxication is best confirmed by measuring lead in ?

A

whole blood

80
Q

% of Lead absorbed in children

81
Q

% of Lead absorbed in adults

82
Q

True or False

Lead is 99% free in plasma, 1% bound to RBCs

A

False

99% bound to RBCs, 1% free in plasma

83
Q

Half-life of Lead in bones

A

Years-Decades

84
Q

Characteristic mechanism of action of Lead

A

Interference with action of essential cations (calcium, zinc, iron)

85
Q

Metabolized via methylation

86
Q

Metabolized via deacylation

A

Organic Mercury

87
Q

Mechanism of Action is Hepatic Dealkylation

A

Organic Lead

88
Q

Dimercaprol, as a single agent, is used to treat acute poisoning of which heavy metals? (2)

A

Arsenic
Inorganic Mercury

89
Q

Used to treat severe lead poisoning in conjunction with EDTA

A

Dimercaprol

90
Q

Used to treat children with blood lead concentration of > 45mg/dL

A

Dimercaptosuccinic Acid (DMSA)

Succimer

91
Q

Second-line oral chelator for iron overload due to blood transfusion in thalassemia major

A

Deferiprone

92
Q

Bidentate iron chelator

A

Deferiprone

93
Q

Tridentate iron chelator

A

Deferasirox

94
Q

Used for oral treatment of iron overload due to blood transfusion in patients with thalassemia major and myelodysplastic syndrome

A

Deferasirox

95
Q

Efficient in decreasing hepatic iron

A

Deferasirox

96
Q

Efficient in decreasing cardiac iron

A

Deferiprone

97
Q

Elemental/Inorganic/Organic Mercury

Causes gingivastomatitis

A

Elemental Mercury

98
Q

Elemental/Inorganic/Organic Mercury

Causes gastroenteritis

A

Inorganic Mercury

99
Q

Elemental/Inorganic/Organic Mercury

Alters microtubules and neuronal structures

A

Organic Mercury

100
Q

Elemental/Inorganic/Organic Mercury

Alters membranes and inhibits enzymes

A

Elemental Mercury
Inorganic Mercury

PCOL MIDTERMS (10 decks)

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