Your discussing with your junior this antidote
Q1What are the toxicology indications for this antidote?
Q2What is the dose and side effects?
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Your discussing with your junior this antidote
Q1What are the toxicology indications for this antidote?
Q2What is the dose and side effects?
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Medication Round Cont'
Thanks Dr Ziad for your comment looking forward for menatox in Oman in May 2022
BAL British anti leweisit , dimercaprol is a chelating agent that is used in the treatment of poisoning by heavy metals , ( arsenic , mercury , lead, gold)
Contraindications :
1- because BAL is dispensed in peanut oil , it should be avoided in patients with peanut allergy
2- use with caution in patients with hepatic and renal impairment ,
3- BAL can cause hemolysis in G6PD deficiency
4- Because BAL is given as IM , injection , use with caution in patients with coagulopathies
Adverse effects:
1- local pain at injection site , sterile or pyogenic accesses
2- dose related hypertension ,
3- GI symptoms , headache , myalgia , fever
4- Burning sensation in eyes ,lips mouth and throat , rhinorrhea, salivation
5- CNS depression and seizure in overdose have been reported
6- It could be associated with redistribution of mercury and arsenic into brain , avoid using in chronic mercury poisoning or methyl mercury poisoning in which brain is the key target organ
Dose :
depends on indication :
1. arsenic , mercury , gold poisoning ,
3 mg/kg , IM, every 4-6 hrs for 2 days then every 12 hrs for 7-10 days
2- Lead encephalopathy : only in conjunction with calcium EDTA , 3-4 mg/kg every 4-6 hrs upto 3 days
References:
Olson Poisoning &Drug Overdose, 6th edition
We recently initiated this antidote on a patient at Grady. Will tell you more about this patient @menatox conference in Oman on May 12 during the Subheya session at 830am.