Dimercaprol, also called British anti-Lewisite ( BAL), is a medication used to treat acute poisoning by arsenic, mercury, gold poisoning, and lead poisoning.[
]
Common side effects include high blood pressure, pain at the site of the injection, vomiting, and fever.[ It is not recommended for people with peanut allergies as it is typically formulated as a suspension in peanut oil.][ It is unclear if use in pregnancy is safe for the baby.][ Dimercaprol is a Chelation and works by chelation.][ It has a very pungent odor.
]
Dimercaprol was first made during World War II.
Medical uses
Dimercaprol has long been the mainstay of chelation therapy for lead or arsenic poisoning,
Wilson's disease is a genetic disorder in which copper builds up inside the liver and other tissues. Dimercaprol is a copper chelating agent that has been approved by the FDA to treat Wilson's disease.
Dimercaprol also shows effectiveness against snakebite by chelating the zinc ions needed for the activity of snake venom metalloproteinases in vitro.
Mechanism of action
Arsenic and some other heavy metals act by chelating with adjacent thiol residues on metabolic enzymes, creating a chelate complex that inhibits the affected enzyme's activity.
Dimercaprol is itself toxic, with a narrow therapeutic range and a tendency to concentrate arsenic in some organs. Other drawbacks include the need to administer it by painful intramuscular injection
Dimercaprol has been found to form stable chelates in vivo with many other metals including inorganic mercury, antimony, bismuth, cadmium, chromium, cobalt, gold, and nickel. However, it is not necessarily the treatment of choice for toxicity to these metals. Dimercaprol has been used as an adjunct in the treatment of the acute encephalopathy of lead toxicity. It is a potentially toxic drug, and its use may be accompanied by multiple side effects. Although treatment with dimercaprol will increase the urinary excretion of cadmium, use in case of cadmium toxicity is to be avoided as the drug-cadmium complex is rather nephrotoxic. It does, however, remove inorganic mercury from the kidneys; Dimercaprol should not be used to treat organomercury poisoning. Dimercaprol also enhances the toxicity of selenium and tellurium, so it is not to be used to remove these elements from the body.
History
The original name of dimercaprol reflects its origins as a compound secretly developed by British biochemists at Oxford University in the beginning of the World War II, with the first synthesis in July 1940
See also
External links
