succimer and monomethylarsonic-acid

Topics: Adolescent; Antidotes; Arsenic; Arsenic Poisoning; Arsenicals; Child, Preschool; Digitaria; Drug Overdose; Female; Gastric Lavage; Herbicides; Humans; Male; Succimer; Suicide, Attempted; Treatment Outcome

Monosodium methanearsonate (MSMA) is an organo-arsenic containing herbicide. There is scant information available concerning the toxicity of this chemical in humans.. Seven male teenagers, 15-18 years of age, inadvertently used a MSMA herbicide as cooking oil to fry fish. All had early gastrointestinal (GI) symptoms. Whole blood arsenic concentrations ranged from 348 to 613 μg/L and initial urine levels ranged from 81 400 to 226 300 μg-arsenic/g-creatinine. They were all treated with dimercaprol for 1 day and succimer for 19 days. They were followed for 15-months and had no evidence of any serious toxicity.. MSMA produces early GI symptoms and very high levels of arsenic in blood and urine, but no evidence of long-term toxicity.

Topics: Accidents, Home; Adolescent; Antidotes; Arsenic Poisoning; Arsenicals; Chelating Agents; Cooking; Dimercaprol; Gastrointestinal Diseases; Herbicides; Humans; Male; Nausea; Succimer; Treatment Outcome; Vomiting

Alkane arsenate herbicides are available commercially, and their acute toxicity has been well documented in previous studies. Animal studies have indicated that dimercaptosuccinic acid (DMSA) can be used as an oral chelating agent. A 20-y-old white male cocaine addict attempted suicide by drinking approximately 500 ml of a 16% monosodium methanearsenate solution. He vomited 10 or more times and was admitted to the intensive care unit with impending shock and early liver and renal involvement. Four 5-day courses of 30 mg DMSA/kg/24 h were given. This brought the serum arsenic level from 2,871 micrograms/L to 6 micrograms/L, and his urine arsenic level from 78,920 micrograms/L to 21 micrograms/L in 30 d. Renal function tests returned to normal, with normal renal creatinine clearance, normal blood urea nitrogen and serum creatinine. However liver functions were abnormal, with elevation of serum transaminases, which later proved secondary to chronic hepatitis. No side effects of DMSA was encountered during the therapy. DMSA was successfully used to detoxify acute organoarsenate poisoning in a clinical setting, supporting experimental reports in the literature.

Topics: Administration, Oral; Adult; Arsenic; Arsenic Poisoning; Arsenicals; Blood Cell Count; Blood Chemical Analysis; Blood Gas Analysis; Chelating Agents; Cocaine; Drug Overdose; Herbicides; Humans; Kidney; Liver; Liver Function Tests; Male; Substance-Related Disorders; Succimer; Suicide, Attempted; Urine