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Skin manifestations of poisoning
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Avoidance of the source of exposure is of utmost importance. Chelation therapy is indicated even in asymptomatic children with blood lead level >45 μg/dL. Dimercaprol or BAL, calcium disodium ethylene diamine tetra-acetic acid (CaNa2EDTA), D-penicillamine, and Meso-2,3-dimercaptosuccinic acid (DMSA), named succimer, are approved for the treatment of acute and chronic lead poisoning [67]. Thiamine in combination with CaNa2 EDTA, vitamins C and E, and garlic all have shown some efficacy in reducing lead-induced oxidative stress [68–70].
Assessing the Toxic Load and Detoxification Strategies
Published in Len Wisneski, The Scientific Basis of Integrative Health, 2017
2,3-Dimercaptosuccinic acid is an sulfhydryl-containing, water-soluble chelating agent developed in the 1950s as an alternative to more toxic chelating agents. DMSA has a half-life of 2–3 hours in the blood and is equally excreted through urine and bile. Several nutrients including alpha-lipoic acid, NAC, probiotics, and fiber have been shown to improve the efficacy of DMSA.
Aging erythrocyte membranes as biomimetic nanometer carriers of liver-targeting chromium poisoning treatment
Published in Drug Delivery, 2021
Qing Yao, Guobao Yang, Hao Wang, Jingzhou Liu, Jinpeng Zheng, Bai Lv, Meiyan Yang, Yang Yang, Chunsheng Gao, Yongxue Guo
Dimercaptosuccinic acid (DMSA) is a new antidote developed in China. Compared to other antidotes, DMSA has many advantages, such as low toxicity, high bioavailability, and strong patient compliance, making it one of the first choices of heavy metal detoxification drugs (Graziano, 1986). After DMSA is administered, two active sulfhydryl groups in the molecule can seize the metals bound to the enzyme system in the tissue to form a stable water-soluble chelate, which is excreted in the urine, and enzymes are free and restore their function, thus, relieving the poisoning symptoms caused by heavy metals (Chen et al., 2014; Ma & Gong, 2014). However, the by-products produced by DMSA after entering the body cause more serious gastrointestinal reactions and hypercomplexation syndrome, which will affect the therapeutic effect and health of the patients. The long-term or one-time use of large doses of DMSA causes damage to liver and kidney function, including irreversible damage. To effectively reduce the damage caused by DMSA to the human liver and kidneys, we considered loading DMSA on nanoparticles and prepare them as biomimetic nanocarriers to achieve a slow-release, reduce the side effects of the drugs in the human body, and improve the bioavailability of the drugs.
The comparison of the resistivity index values in the ultrasonographic evaluation of a unilateral atrophic/hypoplastic kidney
Published in Renal Failure, 2020
Tahir Dalkiran, Yasar Kandur, Besra Dagoglu, Hatice Saki, Sukru Gungor, Sevcan Ipek
The great value of dimercaptosuccinic acid (DMSA) scintigraphy in distinguishing pyelonephritis/atrophy/scars/hypoplastic kidneys has been previously recognized [6]. However, scintigraphy is an expensive examination that is not readily available in all centers, and it also exposes a patient to radiation. On the other hand, renal Doppler investigation is a rapid, noninvasive, painless, safe, and radiation-free technique, which may substantiate subtle renal blood flow changes by using intrarenal resistive index (RI) and allow differentiation of various renal pathophysiological conditions [7–9]. The differentiation of atrophic and hypoplastic kidneys is of clinical importance due to the likelihood of the former to progress. We hypothesized that RI might be a useful marker to differentiate hypoplastic and atrophic kidneys.
Fixed drug eruption due To 2,3-dimercapto-1-propanesulfonic acid (DMPS) treatment for mercury poisoning: a rare adverse effect
Published in Acta Clinica Belgica, 2019
Fatma Erden, Erol Rauf Agis, Meside Gunduzoz, Omer Hinc Yilmaz
Mercury is a highly toxic metal for human body and has a very wide range of uses in many fields such as agriculture, medicine, and industry. In order to prevent some diseases that may develop in various industrial branches associated with this toxic agent, employees are monitored in Ankara Occupational and Environmental Diseases Hospital in certain periods. During visits, appropiate antidotal therapy are given to patients with rising heavy metal levels. Throughout the world, Dimercaptosuccinic acid (DMSA), dimercaprol (BAL), and 2,3-dimercaptopropane-1-sulfonate (DMPS) are the agents used in chelation treatment in patients with high mercury levels [8,9]. Among the first choices for antidotal treatment in mercury exposure, DMPS (Dimaval®) is generally a drug with a low incidence of side effects and containing sulfon group. The most common unexpected effects are allergic skin reactions. It may cause variable skin lesions ranging from mild pruritus, erythematous lesion to erythema multiforme and Steven–Johnson syndrome [5]. FDE due to DMPS was not detected in our literature review. But, DMPS is a drug containing a sulfon group like dapsone and there are FDE cases associated with dapsone [10]. In this clinical presentation, it is possible to think this occured with a mechanism similar to dapsone [10].