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Toxicology A Case-Oriented Approach - part 6 pdf

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The second is inhibition of cytochrome oxidase in a manner very similar to the effect of cyanide.. The nitrites within the kit convert hemoglobin to methemoglobin which becomes an agent

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TOXICITY OF SULFIDES

Hydrogen sulfide has two major toxic actions The first is a depressant effect on the CNS A result of this effect is paralysis of the respiratory center and death The second

is inhibition of cytochrome oxidase in a manner very similar to the effect of cyanide

H2S is actually a more potent inhibitor of cytochrome oxidase than is cyanide Carbon disulfide has some toxic features in common with H2S It attacks the CNS and the cardiovascular system However, it has its own uniquely toxic character

in causing a peripheral neuropathy with cranial nerve damage (see Chapter 10 on neurotoxins) Curiously, it is also atherogenic in experimental animals

THERAPY

The cyanide antidote kit is effective with H2S poisoning The nitrites within the kit convert hemoglobin to methemoglobin which becomes an agent for binding hydro-gen sulfide before it can bind cytochrome oxidase and cause death Sulfmethemo-globin is formed by the reaction between methemoSulfmethemo-globin and either H2S or hydrogen sulfide anion and this substance is excreted into the urine as such or as nontoxic metabolites

LABORATORY TESTING

Hydrogen sulfide is like cyanide in the sense that many victims will die too soon for laboratory evaluation to be of any help However, testing for sulfide ion in blood may help to make the diagnosis for those who are less disabled An ion-selective electrode has been developed for measurement of sulfide ion Because this electrode

is not completely specific to sulfide to the exclusion of all other ions, it is necessary

to pre-treat the specimen and isolate sulfide This has been done, in one method, with Conway microdiffusion cells Concentrations of sulfide ion found in H2S deaths ranged from 1.7 to 3.75 µg/mL

HYDROCARBONS

By definition these are compounds which contain only carbon and hydrogen Many such compounds have been identified in the natural world, a good number of which are found in crude oil They include the aliphatic alkanes, alkenes, and alkynes, which differ among each other in regard to the saturation of the carbon atoms The most common members of this class are methane, ethane, propane, and butane All members of this category are very abundant in the industrial world The aromatic hydrocarbons include benzene and the many compounds derived from benzene Halogenated hydrocarbons and organohalide insecticides are similar to hydro-carbons in some chemical and toxicological properties; however, they also have unique toxicological traits and will be discussed in a separate section of this text

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TOXICITY OF SULFIDES

Hydrogen sulfide has two major toxic actions The first is a depressant effect on the CNS A result of this effect is paralysis of the respiratory center and death The second

is inhibition of cytochrome oxidase in a manner very similar to the effect of cyanide

H2S is actually a more potent inhibitor of cytochrome oxidase than is cyanide Carbon disulfide has some toxic features in common with H2S It attacks the CNS and the cardiovascular system However, it has its own uniquely toxic character

in causing a peripheral neuropathy with cranial nerve damage (see Chapter 10 on neurotoxins) Curiously, it is also atherogenic in experimental animals

THERAPY

The cyanide antidote kit is effective with H2S poisoning The nitrites within the kit convert hemoglobin to methemoglobin which becomes an agent for binding hydro-gen sulfide before it can bind cytochrome oxidase and cause death Sulfmethemo-globin is formed by the reaction between methemoSulfmethemo-globin and either H2S or hydrogen sulfide anion and this substance is excreted into the urine as such or as nontoxic metabolites

LABORATORY TESTING

Hydrogen sulfide is like cyanide in the sense that many victims will die too soon for laboratory evaluation to be of any help However, testing for sulfide ion in blood may help to make the diagnosis for those who are less disabled An ion-selective electrode has been developed for measurement of sulfide ion Because this electrode

is not completely specific to sulfide to the exclusion of all other ions, it is necessary

to pre-treat the specimen and isolate sulfide This has been done, in one method, with Conway microdiffusion cells Concentrations of sulfide ion found in H2S deaths ranged from 1.7 to 3.75 µg/mL

HYDROCARBONS

By definition these are compounds which contain only carbon and hydrogen Many such compounds have been identified in the natural world, a good number of which are found in crude oil They include the aliphatic alkanes, alkenes, and alkynes, which differ among each other in regard to the saturation of the carbon atoms The most common members of this class are methane, ethane, propane, and butane All members of this category are very abundant in the industrial world The aromatic hydrocarbons include benzene and the many compounds derived from benzene Halogenated hydrocarbons and organohalide insecticides are similar to hydro-carbons in some chemical and toxicological properties; however, they also have unique toxicological traits and will be discussed in a separate section of this text

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CONTENTS

Organochlorine Insecticides

Chemistry

Benzene Hexachloride (Hexachlorocyclohexane)

Cyclodienes

Cage Structures

Symptoms of Organochlorine Poisoning

Therapy

Organophosphate Insecticides

Chemistry

Physiology of Cholinergic Activity

Characteristics of Organophosphate Poisoning

Therapy

Laboratory Testing

Carbamates

Pyrethrins

Questions and Problems

Insecticides are very beneficial to mankind because they help to control vector-borne diseases such as malaria, improve agricultural productivity, and reduce the angst which many forms of insects visit upon “picnicking man.” Ideally, they should be entirely species-specific or, at least, specific to invertebrates This is, of course, not the case Some insecticides are much more lethal to insects than to higher forms of life Nonetheless, because they are harmful to all forms of life, at least to some degree, exposure to them can be fatal and they must be discussed in texts on toxicology

ORGANOCHLORINE INSECTICIDES

The chlorinated hydrocarbon group of insecticides is large and includes what is possibly the most controversial compound of the twentieth century, DDT, dichlo-rodiphenyltrichloroethane (Figure 17.1) It was synthesized 125 years ago in 1874 but its ability to eliminate insect pests was not recognized until 1939 That recog-nition led to the 1948 Nobel prize for the responsible scientist, Dr Paul Mueller, a Swiss chemist Mueller discovered the potency of DDT while screening for insec-ticides for the JR Geigy Company

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CONTENTS

Arsenic

History

Forms of Arsenic

Sources of Arsenic

Mechanism of Arsenic Toxicity

Symptoms of Arsenic Poisoning

Treatment

Chelators

Chelating Agents for Use with Arsenic Poisoning Testing for Arsenic

Lead

History

Sources of Lead

Pharmacokinetics of Lead

Mechanism of Toxicity

Symptoms of Lead Poisoning

Treatment of Lead Intoxication

The Laboratory and Lead Overdose

Mercury

History

Types and Sources of Mercury

Toxicokinetics of Mercury

Signs of Mercury Poisoning

Treatment of Mercury Poisoning

Laboratory Testing and Mercury

Iron

Toxicokinetics

Iron Toxicity

Treatment

Deferoxamine (Deferoxamine Mesylate, Desferal) Laboratory Involvement

Laboratory Testing Methods

Questions and Problems

Further Reading

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