how to treat lead and mercury poisoning

1. Treatment of lead
poisoning
Treatment of
mercury poisoning
By: mina
sam

2. 1- The mainstays of treatment are removal from the source of lead.
2- When lead-containing materials are present in the gastrointestinal
tract
(as evidenced by abdominal X-rays), whole bowel irrigation ,
cathertics , endoscopy to eliminate it from the gut and prevent further
exposure.
3- for people who have significantly high blood lead levels or who
have symptoms of poisoning, chelation therapy indicated:-
Treatment of lead
poisoning

3. . A chelating agent is a molecule with at least two negatively charged groups that
allow it to form complexes with metal ions with multiple positive charges, such as
lead.
. The chelating agents used for treatment of lead poisoning are:
D-penicillamine: 20-40 mg/kg/24hr which are administered orally in 4 divided
doses for 5 days.
(sodium calcium EDTA): 20-30 mg/kg/24hr via continuous
IV infusion for 3-5 days
4- Lead encephalopathy has traditionally been treated using:
dimercaprol (British anti-Lewisite, BAL)
and calcium disodium ethylenediaminetetraacetic acid
(CaNa2EDTA).

4. 1- Identifying and removing the source of the mercury is
crucial.
2- Supportive treatment: (ABC)
. Administration of oxygen or assisted ventilation.
. Treat hypotension in patients with inorganic mercury
ingestions.
3- Decontamination: ingestion of inorganic mercury salts
requires gastric lavage.
Treatment of
mercury poisoning

5. 4- Physiological antidotes=chelators:
D-penicillamine: it is given orally at a dose of 20mg/kg/day
Up to 1g a day, in 4 divided doses for 5 days.
Dimercaprol (BAL): it is given as an I.M injection of 10% solution in oil.
A- the recommended dose is 3-5 mg/kg every 4h for 48 hours, followed by
2.5-3.0 mg/kg every 6h for 48 hours and then 2.3-3.0 mg/kg every 12h for 7
days.
B- if urinary output diminished after chelation with BAL, hemodialysis should
be considered as the BAL-mercury complex is dialyzable.
C- Derivatives of BAL: are less toxic and more specific therapies: e.g:
Dimercaptosuccinic acid (DMSA) orally.
N.B: CA-EDTA should not be used as it is nephrotoxic in combination with
mercury.