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Flashcards in chelation Deck (16):
1

BAL (british antilewiste), what is it and how does it work

dimercaprol. dithiol of a 2 adjacent sulfur groups which forms a ring structure upon electron pair donation and coordinate bonding to a metal. forms a stable chelate.

2

how do we use BAL

solubilized in peanut oil and injected.

3

what is BAL used to treat?

inorganic mercury and arsenic. also given with cana2EDTA in treatment for lead encephalopathy to prevent the redistribution of the lead to the brain.

4

what happens to BAL-chelate in acidic urine

it destabilizes decreasing urine excretion. urine alkalinization prevents thisl

5

what are the adverse effects of the BAL treatment

pain at injection, nausea, vomit, fever, fat emboli, lipoid pneumonia, chylothorax and hypoxia.

6

succimer

dimercaptosuccinic acid. is a dicarboxylic acid with 4 ionizable hydrogens. lead, arsenic, mercury, and cadmium all chelat.e

7

how do we give succimer

oral.

8

what does the succimer treat

lead, increases renal excretion.

9

what are the side effects of succimer

well tolerated, nausea, vomit, flatus, diarrhea, metallic taste, mild elevation of ALT/AST.

10

edetate calcium disodium

treatment of lead poisoning used together with BAL in severe lead encephalopathy. reverses the toxic effects of lead on the Hb.

11

how do we give edetate calcium

IM or IV where is remains in the blood.

12

what does it do to lead in the body

it mobilizes it from the tissues to the bone to the chelate. this is why we give BAL to block the redistribution to the brain.

13

what to watch out for when treating with edetate

nephrotoxicity

14

prussian blue

ferric hexacyanoferrate. thallium and radioactive cesium. hydrated crystal ferrous and ferric iron are coordinated ina cubic lattice chelation occurs through ion-exchange with iron and trapping in the lattice

15

how do we give prussian blue

orally and it is not absorbed through the gut. this prevents absorption, mobilizes body stores to the GI and then chelates it

16

SE of prussian blur

well tolerated since never absorbed