Inorganic arsenic toxicosis Flashcards Preview

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Flashcards in Inorganic arsenic toxicosis Deck (25):
1

Sources

- ant and cockroach bait (ewwww)
- wood preservatives
- insecticides, herbicides, yada yada
- pastures near smelters
- pass to baby cow in milk

2

What are the three states

- elemental
- trivalent (arsenite)
- pentavalent (arsenate)

3

What does arsenic react with

- SH

4

Toxicity

everything except chronic

5

Susceptibility

- Most = herbivores
- dogs eat it
- swine and chickens = rare

6

Which is most toxic

Inorganic trivalent

7

Which is middle toxic

Pentavalent

8

Which is least toxic

organic

9

Pentavalent can be converted to

trivalent when in liver

10

Toxicokinetics

- absorbed from GI, intact skin, inhalation
- high distribution
- poorly crosses BBB

11

Where is inorganic arsenic excreted

- urine (within 48 hrs)
- feces, milk, saliva, sweat, hair, exhalation

12

MOA

- trivalent binds to lipoic acid
- lipoic acid is needed for glycolysis and TCA
- interferes with vitamin B metabolism
- locally corrosive

13

Which tissues are most sensitive

- capillary endothelial cells are the most sens.
- those with the most oxidative enzymes - aka intestines, liver, kidneys

14

Peracute clinical signs

- sudden death, severe colic, collapse

15

Acute signs

- rapid onset
- severe colic, staggering, slivation, vomiting, thirst, diarrhea +/- hemorrhagic, hematuria
- death in 1-3 days

16

Subacute signs

- colic, anorexia, depression
- diarrhea with blood
- dehydration
- partial paralysis of hind limbs
- death in several days

17

Lesions

- GI mucosal edema and hemorrhage with perforation
- liver and kidney damage
- capillary degeneration
- skin lesions

18

Chemical tests

- Urine is best specimen when alive
- liver and kidney is best when dead

19

Lab results

- Increased PCV
- Increased BUN

20

Treatment

- Fluids and electrolytes
- possibly blood transfusion
- treatment of acidosis
- vitamins, antibiotics, analgesics, dopamine

21

Decontamination

- Gastric lavage= ONLY if early
- mineral oil
- activated charcoal
- Demulcents

22

What is contraindicated in decontamination!

- Emetics and strong cathartics

23

Chelation therapy

- Dimercaprol
- BAL
- chelator of choice but not 100% effective
- has toxic side effects

24

Dimercaptosuccinic acid (DMSA)

- Water soluble analog of BAL
- Safer but less effective

25

Prognosis

Grave if not treated early