Shum S, Whitehead J, Vaughn L, Shum S, Hale T
Texas Poison Center Network at Amarillo 79106, USA.
Vet Hum Toxicol. 1995 Jun;37(3):239-42.
Alkane arsenate herbicides are available commercially, and their acute toxicity has been well documented in previous studies. Animal studies have indicated that dimercaptosuccinic acid (DMSA) can be used as an oral chelating agent. A 20-y-old white male cocaine addict attempted suicide by drinking approximately 500 ml of a 16% monosodium methanearsenate solution. He vomited 10 or more times and was admitted to the intensive care unit with impending shock and early liver and renal involvement. Four 5-day courses of 30 mg DMSA/kg/24 h were given. This brought the serum arsenic level from 2,871 micrograms/L to 6 micrograms/L, and his urine arsenic level from 78,920 micrograms/L to 21 micrograms/L in 30 d. Renal function tests returned to normal, with normal renal creatinine clearance, normal blood urea nitrogen and serum creatinine. However liver functions were abnormal, with elevation of serum transaminases, which later proved secondary to chronic hepatitis. No side effects of DMSA was encountered during the therapy. DMSA was successfully used to detoxify acute organoarsenate poisoning in a clinical setting, supporting experimental reports in the literature.
烷基亚砷酸除草剂在商业上是可获得的，并且它们的急性毒性在先前的研究中已有充分记录。动物研究表明，二巯基丁二酸（DMSA）可作为口服螯合剂。一名20岁的白人男性可卡因成瘾者饮用了约500毫升16%的甲基胂酸钠溶液企图自杀。他呕吐了10多次，因即将发生休克以及早期肝脏和肾脏受累而被收入重症监护病房。给予了四个疗程、为期5天、剂量为30毫克DMSA/千克/24小时的治疗。这使血清砷水平在30天内从2871微克/升降至6微克/升，尿液砷水平从78920微克/升降至21微克/升。肾功能测试恢复正常，肾肌酐清除率、血尿素氮和血清肌酐均正常。然而肝功能异常，血清转氨酶升高，后来证明是继发于慢性肝炎。治疗期间未遇到DMSA的副作用。DMSA在临床环境中成功用于急性有机胂酸盐中毒的解毒，支持了文献中的实验报告。
