Chelator pharmacology FINAL test Flashcards

1
Q

How do chelators work on heavy metals?

A

-Render heavy metal ions unavailable for covalent interactions

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2
Q

How does the half life of the heavy metal affect the ability of a chelator to remove it from a target organ?

A

-The longer the 1/2 life the less effective is the chelator

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3
Q

Is it better to treat with chelators quickly or take a wait and see approach when exposure has occurred?

A

-Usually most effective when treated ASAP

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4
Q

What are four chelators?

A
  • Dimercaprol
  • Unithiol
  • Succimer
  • Edetate calcium disodium
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5
Q

Dimercaprol is FDA approved for which heavy metal poisonings as a monotherapy?

A
  • Acute arsenic

- Acute Mercury

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6
Q

Dimercaprol can be administered with edetate calcium disodium to treat chronic poisoning with what heavy metal?

A

-Severe lead poisoning

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7
Q

Why should dimercaprol no be given as a monotherapy after chronic exposure to lead?

A

-It pulls Pb from bone and it goes to brain and causes toxicity?

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8
Q

Is dimercaprol water soluble?

A

-No

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9
Q

What is the only route of administration of dimercaprol?

A

-IM route only

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10
Q

How does the therapeutic index of dimercaprol compare to succimer or unithiol?

A

-It can be very toxic, especially on kidneys

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11
Q

T/F Succimer has for the most part eplaced dimercaprol

A

True

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12
Q

Unithiol is a water soluble derivative of what other chelator?

A

-Dimercaprol

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13
Q

What are the routes of administration of unithiol?

A
  • Orally

- IV

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14
Q

How does the half life of unithiol’s compare to the other chelators?

A

-20 hours, which is much longer than other chelators

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15
Q

What heavy metal poisonings is unithiol FDA approved to treat?

A

-None

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16
Q

What heavy metal poisoning is unithiol effective against?

A
  • Mercury
  • Arsenic
  • Lead
  • it is effective against these, just not FDA approved to treat
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17
Q

What is the water soluble form of dimercapro?

A
  • Succimer

- Also unithiol

18
Q

What heavy metal poisonings is Succimer FDA approved for?

A
  • Treat Lead
  • Arsenic
  • Mercury
19
Q

What is the main mechanism of succimer for removing heavy metals?

A

-Binds to cysteine to form mixed disulfides which are excreted

20
Q

What is the half life of succimer?

A

2-4 hrs

21
Q

What is the only route of administration of succimer?

A

-Oral use only

22
Q

What is safer, Dimercaprol or succimer?

A

-Succimer, which is why it is preferred over dimercaprol

23
Q

What heavy metal poisoning is Edetate calcium disodium FDA approved for?

A

-Lead poisoning

24
Q

Does Edetate calcium disodium target intracellular or extracellular lead?

A

-Only extracellular

25
Q

What is the only route of administration for Edetate calcium disodium?

A

-IV

26
Q

What is the half life of Edetate Calcium disodium?

A

-1 hour

27
Q

How is edetate calcium disodium excreted?

A

-100% by the kidneys

28
Q

In what patient population is edetate calcium disodium contraindicated in?

A

-Anuric patients because it is excreted by the kidneys (can’t be cleared because anuric patients don’t produce urine)

29
Q

What are the four criteria for dental material biocompatibilty?

A
  • Should not be harmful to pulp or soft tissues
  • Should not contain toxic diffusible substances that may be released and absorbed into the circulatory system to cause systemic toxicity
  • Should be free of potentially sensitizing agents that may promote reactions
  • Should have NO carcinogenic potential
30
Q

What step in amalgam fillings results in the greatest release of mercury?

A

-Dry polishing of an amalgam filling

31
Q

How can a dentist prevent lesions caused by zinc phosphate cement?

A

-Use proper mix or use a resin modified GI cement instead

32
Q

How can a dentist reduce the cytotoxicity of acrylate bonding agents?

A

-Adequately rinse with tap water between applications of subsequent reagents

33
Q

What is Anthracosis?

A

-Inhalation of carbon dust resulting in chronic dry cough

34
Q

what are the common allergic reactions observed in dental practices?

A
  • allergic contact dermatitis
  • latex allergies
  • allergies to denture-based materials
35
Q

what steps can be taken to prevent pulpitis caused by unpolymerized monomers in resin composites used in deep fillings?

A

-use twice the recommended time of exposure and cure in increments to assure complete curing

36
Q

why is adequate ventilation and use of exhaust fans essential if working with metals in the laboratory?

A

-because dust/vapors from these materials can to exposure and toxicity

37
Q

___ is described as materials that elicit an appropriate biological response, without toxic or adverse immunological response, when exposed to the body or bodily fluids

A

-biocompatibility

38
Q

dimercaptopropanesulfonic acid is also known as ___

A

-unithiol

39
Q

CaNa2-EDTA is also known as ___

A

-edetate calcium disodium

40
Q

dimercaprol can be administered with edetate calcium disodium to treat severe, chronic poisoning of what heavy metal?

A

-lead