Heavy Metals VS The Chelators (edit required).pptx

It is about pharmacology

1. THE HEAVY METALS VS THE "CHILL"ATORS START

2. PRESENTATION BY TEAM J (119-131) PRESENTERS NEHA ALI 120 ONZELA ARIF 122 NEHAL AHMED 121 PRESENTATION SAIM SALEEM 127

3. The Metals The “ Chillators ” Final Boss

4. THE METALS LEAD MERCURY ARSENIC IRON

5. THE METALS LEAD ARSENIC IRON TREATMENT POISONING EXPOSURE Water- drinking water can pick up lead Paint- until 1978, lead was commonly used in paint Soil- in urban areas can be contaminated with lead Products- household items like toys, dishes or jewelry Tracking in- Adults working in industries that involve lead can track it into their homes on clothes LEAD LEAD

6. THE METALS LEAD MERCURY ARSENIC IRON TREATMENT EXPOSURE POISONING Lead Levels (ug/dl) Clinical Symptoms Acute Poisoning 100-120 Muscle pain, fatigue, abdominal pain, headache, vomiting seizures and coma Chronic Poisoning 40-60 Persistent vomiting, encephalopathy, lethargy, delirium, convulsions and coma BURTONIAN LINE IN CHRONIC LEAD POISONING

7. THE METALS LEAD MERCURY ARSENIC IRON EXPOSURE POISONING TREATMENT

8. THE METALS LEAD MERCURY ARSENIC IRON TREATMENT POISONING SOURCES NON ORGANIC MERCURY : ​ mercury-containing materials in dental laboratories  ​ In the manufacture of wood preservatives, insecticides, and batteries ​ ORGANIC MERCURY: used as seed dressing ​ Fungicides ​

9. THE METALS LEAD MERCURY ARSENIC IRON SOURCES TREATMENT POISONING Acute mercury Poisoning: ​ Route : Inhalation of inorganic elemental mercury ​ Symptoms  of poisoning: ​ Chest pain ​ Shortness of breath ​ Nausea and vomiting ​ Kidney damage ​  Gastroenteritis ​ CNS damage ​ Hemorrhagic gastroenteritis followed by  acute tubular necrosis and oliguric renal failure ​ ​ Chronic mercury poisoning: ​ Route: ​ GIT: ​ Inorganic or organic mercury  Inhalation:  ​  mercury vapor  ​ Symptoms: ​  gums and teeth changes ​ (blue black line)  gastrointestinal disturbances  ​ ERETHISM includes HATTERS SHAKE Irritability Insomnia Shyness Memory Loss  

10. THE METALS LEAD MERCURY ARSENIC IRON SOURCES POISONING TREATMENT   TREATMENT

11. THE METALS LEAD MERCURY ARSENIC IRON TREATMENT POISONING SOURCES  

12. THE METALS LEAD MERCURY ARSENIC IRON SOURCES TREATMENT POISONING   Acute Poisoning Pain, Metallic Taste, RICE WATER STOOL , skin eruptions, Chronic Poisoning  1. Stage of GIT  2.  Stage of Catarrhaal changes  3. Stage of skin rashes  4. Stage of Nervous Disturbances General Appearance Cold clammy skin Sunken eyes Jaundice, Liver and Kidney Necrosis

13. THE METALS LEAD MERCURY ARSENIC IRON SOURCES POISONING TREATMENT   Antidote: Ferrous oxide (combine with arsenic and make ferric arsenite ) Dimercaprol IV fluids (I’m Salt & Glucose) I forIce , M for morphine, Salt for sodium bicarbonate and Glucose Decontamination or stomach wash. Demulcents like Butter & Greasy. Substance are given which decrease the solubility of metal while alkalies are avoided asthey increase the solubility.

14. THE METALS LEAD MERCURY ARSENIC IRON TREATMENT POISONING SOURCES   Blood transfusions Iron is present in many multivitamins

15. THE METALS LEAD MERCURY ARSENIC IRON SOURCES TREATMENT POISONING  

16. THE METALS LEAD MERCURY ARSENIC IRON SOURCES TREATMENT POISONING  

17. THE METALS LEAD MERCURY ARSENIC IRON SOURCES POISONING TREATMENT   Decontamination Stomach wash Defurroxamine given parenterally Or Defurrosorixe given orally.

18. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe

19. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe s. EFFECTS INDICATIONS PROPERTIES Oily colorless liquid Also known as BAL (British Anti Lewsite ) Dispensed in peanut oil.

20. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe s. EFFECTS PROPERTIES INDICATIONS Arsenic Inorganic Mercury Treatment of severe lead poisoning. Don’t give in chronic lead poisoning as it distributes the mercury in the CNS

21. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe PROPERTIES INDICATIONS S.EFFECTS Hypertension Tachycardia Nausea Vomiting Lacrimation Salivation Fever Thrombocytopenia

22. THE "CHILL"ATORS DIMERCAPROL SUCCIMER Defurroxamine & Defurrosurixe Structure: Organosulfur compound with 2 sulfhydryl groups that bonds divalent metal ions S.EFFECTS INDICATIONS PROPERTIES Pharmacokinetics: Absorbed rapidly but incompletely after oral administration but through active transporter. MAO: Binds with high specificity to ions of lead in blood to form water soluble complex that is secreted in kidney

23. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe Acute lead poisoning, Mercury Arsenic Poisoning. PROPERTIES S.EFFECTS INDICATIONS

24. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe Nausea Vomiting Anorexia skin rashes CNS effects increased liver enzymes PROPERTIES INDICATIONS S. EFFECTS

25. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe S.EFFECTS INDICATIONS PROPERTIES EDTA: Ethylenediaminetetraacetic acid Mechanism of Action Chelator of many divalent and trivalent metals e.g Calcium Route Of Administration Parenteral (Because It is highly polar) Interactions Administered as calcium disodium salt to avoid calcium depletion (Hypocalcemia)

26. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe S. EFFECTS PROPERTIES INDICATIONS Emergency treatment of hypercalcemia Acute and chronic lead poisoning

27. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe PROPERTIES INDICATIONS S.EFFECTS Nephrotoxicity (renal tubular necrosis) ECG changes ( At high doses )     Prevention Of Nephrotoxicity Risk can be reduced by adequate hydration and restricting treatment with EDTA to 5 days or less

28. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe S. EFFECTS INDICATIONS PROPERTIES Deferoxamine Deferasorix Poor oral absorption, IM and Subcutaneous route Oral absorption 70% in suspension form Plasma protein binding 99% protein binding Metabolised by plasma enzymes Metabolized by liver enzymes Continuous infusion required due to short half life (30 min to 1 hr ) Half life greater (8 to 16 hrs ) Some excretion by bile some by kidney Excretion via bile and kidneys Can chelate iron (ferric form) and aluminium Selective to ferric iron, two molecules of defarrosorix bind to 1 iron atom.

29. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe PROPERTIES S.EFFECTS INDICATIONS Deferoxamine: Iron and Aluminium Toxicity patients with anemia who must receive many blood transfusions Deferasorix : treatment of chronic iron overload due to blood transfusions ( transfusional hemosiderosis) in patients 2 years of age and older

30. THE "CHILL"ATORS DIMERCAPROL SUCCIMER EDTA Defurroxamine & Defurrosurixe PROPERTIES INDICATIONS S.EFFECTS Deferoxamine: Allergic reactions Vision defects Hearing loss Zinc deficiency Lung toxicity Retarded growth in children Deferasorix : GI distress Renal complications Allergic reaction Fever headache Increased serum creatinine & liver enzymes

31. Following Sunday morning services, 27 people attended a church social where coffee, baked goods, and sandwiches were served. Within 15–60 minutes, 13 people developed vomiting and abdominal discomfort , accompanied over the next several hours by nonbloody diarrhea . Within 12 hours, seven of these individuals were hospitalized with ongoing gastrointestinal symptoms, hypotension, and anion gap metabolic acidosis . Fluid resuscitation and pressors were accompanied by adequate urine output. What diagnoses should be considered? What tests should be conducted, and what therapy should be considered?

32. METALS CHILLATORS

33. METALS CHILLATORS

34. METALS CHILLATORS

35. METALS CHILLATORS

36. METALS CHILLATORS

37. METALS CHILLATORS

38. METALS CHILLATORS

39. METALS CHILLATORS

40. METALS CHILLATORS YOU WIN Warning: scenes depicted in this game should not be copied in real life. a.k.a DONOT THROW DIMERCAPROL AT YOUR PATIENT.