3 - Heavy Metals

Question 1

What are the mechanisms of action of heavy metals?

Answer 1

• Disrupt enzymatic and transport process
• Loss of energy production
• Loss of ion regulation
• Potential carcinogenesis

Question 2

What does arsenic (As) naturally occur as?

Answer 2

arsenopyrite - most common arsenic containing mineral

Question 3

What are the effects of arsenic?

Answer 3

• Dermatological
• Vasodilation
• GI effects
• CNS
• Headache
• Coma
• “garlic breath”
• Teratogenic
• Carcinogenic

Question 4

What is used to treat arsenic poisoning?

Answer 4

• Dimercaprol (BAL - British Anti-Lewisite), dithioglycerol

Question 5

What is the antidote for antimony?

Answer 5

dimercaprol

Question 6

What is argyria and what causes it?

Answer 6

Bluish-grayish pigmentation of skin and mucous membranes, permanent - from silver and silver containing compounds

Question 7

What are the signs of gold toxicity?

Answer 7

• Dermatitis
• Metallic taste in mouth
• Proteinuria
• GI symptoms
• Aplastic anemia

Question 8

What’s the antidote for gold?

Answer 8

dimercaprol or penicillamine

Question 9

What are the symptoms of people exposed to mercury?

Answer 9

• Tremors
• Impaired cognitive skills
• Sleep disturbance

With acute exposure:

• Chest pain
• Dyspnea
• Cough
• Hemoptysis
• Pulmonary function impairment
• Interstitial pneumonia

Question 10

What’s the difference between elemental and inorganic mercury?

Answer 10

• Elemental
  
  • Aquired in food (fish)
  • Neurotoxic
  • Acute poisoning = pneumonitis
• Inorganic
  
  • Amalgam
  • Kidney damage, corrosive to oral cavity

Question 11

What are the antidotes for mercury?

Answer 11

• dimercaprol or penicillamine
• N-acetyl-D
• L penicillamine

Question 12

What is the enzyme inhibitor in the production of heme?

Answer 12

Lead (Pb)

Question 13

What are the antidotes of lead?

Answer 13

Combination - calcium EDTA and dimercaprol

Question 14

What’s similar to lead poisoning, and inhibits the same processes as lead?

Answer 14

Cadmium

Question 15

What is the antidote to Iron and Aluminum?

Answer 15

deferoxamine

Question 16

What’s the antidote to Nickel?

Answer 16

diethylthiocarbamate trihydrate