Arsenic Toxicity: How Should Patients Overexposed to Arsenic Be Treated and Managed? | Environmental Medicine (2024)
Gut decontamination and hemodynamic stabilization are key factors in the initial management of acute arsenic intoxication.
Patients with suspected acute arsenic poisoning generally require rapid stabilization with fluid and electrolyte replacement in an intensive care setting.
Aggressive intravenous fluid replacement therapy may be life–saving in severe poisoning.
Gastric lavage may be useful soon after an acute ingestion to prevent further absorption.
The efficacy of activated charcoal is controversial, but its administration together with a cathartic (such as sorbitol) is frequently recommended.
If profuse diarrhea is present, cathartics should be withheld.
Hemodialysis may be beneficial in a patient with concomitant renal failure.
Chelating agents administered within hours of arsenic absorption may successfully prevent the full effects of arsenic toxicity.
Dimercaprol (2, 3 dimercaptopropanol, also known as British anti Lewisite or BAL), was previously the most frequently recommended chelating agent for arsenic. The currently recommended treatment is 2-3-dimercapto-1-propanesulfonate (DMPS) or meso 2, 3-dimer-captosuccinic acid (DMSA). These are more water soluble than BAL, and can be administered orally with lower toxicity [Mazumder et. al. 2001].
All known chelating agents have adverse side effects and should be used with caution.
In animal models, the efficacy of chelation therapy generally declines as the time elapsed since exposure increases.
If patients are treated within several hours after arsenic ingestion, chelation is likely to be beneficial. Therefore, even if arsenic ingestion is only suspected, but not confirmed, consultation with a clinical specialist with expertise in the treatment and management of arsenic poisoning is key.
Data supporting duration of treatment are limited, and regimens may warrant adjustment. If acute renal insufficiency develops, hemodialysis may be of value.
If the source of arsenic exposure has not been determined, the patient may be at risk for further arsenic intoxication.
Arsenic poisoning (or arsenicosis) is a medical condition that occurs due to elevated levels of arsenic in the body. If arsenic poisoning occurs over a brief period of time, symptoms may include vomiting, abdominal pain, encephalopathy, and watery diarrhea that contains blood.
https://en.wikipedia.org › wiki › Arsenic_poisoning
generally require rapid stabilization with fluid and electrolyte replacement in an intensive care setting. Aggressive intravenous fluid replacement therapy may be life–saving in severe poisoning.
In severe cases, medicines called chelating agents are given to remove arsenic from the body and eliminate it in the urine. Severely affected individuals must be hospitalized. In some cases, permanent nerve damage can result even if chelation therapy is used.
Your healthcare provider may give you chelation therapy. This treatment uses certain chemicals to separate the arsenic from your blood proteins. You may also receive bowel irrigation. With this treatment, a special solution flushes out the contents of your gastrointestinal tract.
The nature of the effects depends on the species and time of exposure. The effects include death, inhibition of growth, photosynthesis and reproduction, and behavioral effects. Environments contaminated with arsenic contain only a few species and fewer numbers within species.
The most cost effective method for removing arsenic from a domestic water supply appears to be reverse osmosis (RO). RO can be thought of as atomic scale filtration. It works by squeezing water through a special membrane.
Long-term exposure to high levels of inorganic arsenic in drinking water is associated with certain medical conditions. These conditions include skin disorders, an increased risk for diabetes, high blood pressure, and several types of cancer.
Arsenic is excreted in the urine primarily through the kidneys. Humans excrete a mixture of inorganic, monomethylated, and dimethylated (but not trimethylated) forms of arsenic. The pentavalent metabolites MMA V and DMA V are less toxic than arsenite or arsenate [Marafante et al. 1987].
Immediately remove the patient/victim from the source of exposure.Immediately wash eyes with large amounts of tepid water for at least 15 minutes. If irritation is severe or persists, prolonged irrigation is advised. Seek medical attention immediately.
Both inorganic and organic forms leave your body in your urine. Most of the inorganic arsenic will be gone within several days, although some will remain in your body for several months or even longer. If you are exposed to organic arsenic, most of it will leave your body within several days.
People in the general population may be exposed to arsenic by smoking tobacco, being around tobacco smoke, drinking contaminated water, or eating food from plants that were irrigated with contaminated water.
Arsenic (As) enters the environment through natural processes and anthropogenic activities, such as volcanic activity, mineral rock erosion, pesticides, fertilizers, preservatives, etc.
Wear appropriate protective clothing such as coveralls, gloves, impervious boots, hat, goggles or a face shield whenever there is a likelihood of skin contact with arsenicals. 3. Wear a respirator if the airborne concentration of arsenic compounds exceeds the OSHA PEL.
This discovery led to the idea that brake fern could help clean up arsenic- contaminated soil. The use of plants to clean up contaminated soil and water is called phytoremediation.
There's no specific method used to treat arsenic poisoning. The best way to treat the condition is to eliminate arsenic exposure. Full recovery may not happen for weeks or months. It all depends on how long you've been exposed.
Both inorganic and organic forms leave your body in your urine. Most of the inorganic arsenic will be gone within several days, although some will remain in your body for several months or even longer. If you are exposed to organic arsenic, most of it will leave your body within several days.
Immediately remove the patient/victim from the source of exposure.Immediately wash eyes with large amounts of tepid water for at least 15 minutes. If irritation is severe or persists, prolonged irrigation is advised. Seek medical attention immediately.
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