Dimercaprol 100mg/2ml solution for injection ampoules

Propyl-propane-thiosulfonate (PTSO) is an organosulfur compound found inAllium spp. Due to its antioxidant and antimicrobial activities, PTSO has been proposed for applications in the agri-food sector, such as feed additive. However, its use with commercial purposes depends on its toxicity evaluation. The present work aimed to perform a pilot-study of toxicokinetic profile of PTSO combining in silico and in vitro techniques, important steps in the risk assessment process. In silico ecotoxicity studies were also performed considering the importance of the environmental impact of the compound before its commercial use. First, an analytical method has been developed and validated to determine the original compound and its metabolites by ultra-performance liquid chromatography-tandem mass spectrometry. The phase I and II metabolism of PTSO was predicted using Meta-Pred Web Server. For the phase I metabolism, rat (male and female) and human liver microsomes were incubated with PTSO and NADPH regeneration system. Furthermore, in the phase II, microsomes were incubated with PTSO and glutathione or uridine 5'- diphosphoglucuronic acid. The analysis revealed the presence of propylpropane thiosulfinate (PTS) originated by redox reaction in phase I, and two conjugates from the phase II: S-propylmercaptoglutathione (GSSP) and S-propylmercaptocysteine (CSSP). Additionally, considering the environmental fate of PTSO and its metabolites, the ADME parameters and the potential ecotoxicity were also predicted using in silico softwares. The results of the ecotoxicity in silico study evidenced that the metabolism induced the formation of detoxified metabolites from the parent compound, except for dimercaprol and 3-mercaptopropane1,2-diol. Further in vivo assays are needed to confirm this prediction.

Abstract licence: CC BY-NC-ND

This study analyzes the activities, poisoning, and medical treatment of the "La Esperanza" mercury mine workers in Aranzazu (Caldas, Colombia) between 1948 and 1975. The mining work there was difficult due to the geological instability of the area and the use of inappropriate mining technology, which generated a high occurrence of poisoning manifested in tremors of limbs, bleeding gums, loss of teeth, and bad mouth odor. The mine was the first Colombian company to treat its poisoned workers with dimercaprol and penicillamine. Occupational toxicology in Colombia was thus born during one of the most significant occupational health disasters in the country.

Abstract licence: CC BY

IntroductionAcute copper toxicity is a rare occurrence, and management guidelines are not based on robust evidence. Treatment recommendations are often extrapolated from those of chronic copper intoxication and the management of Wilson's disease. Although D-penicillamine, EDTA, and dimercaprol have varying success, we describe the use of chelation with succimer monotherapy in a patient with acute copper salt ingestion with subsequent improvement of clinical status and copper concentrations.Case reportA 38-year-old woman presented to an ED after ingestion of liquid copper fungicide containing 27.5% copper diammonia diacetate complex. The regional poison center initially recommended D-penicillamine along with supportive care. Due to the lack of availability of D-penicillamine, succimer was chosen as an alternative agent. The patient developed mild hemolysis and liver injury during her stay, but did not develop any kidney injury. She had a Zargar 2A caustic injury to the stomach and duodenal bulb. She received succimer for a total of 10 days, and copper concentrations decreased from 1,295 mcg/dL (reference range: 80-158 mcg/dL) to normal levels before discharge.DiscussionThere is limited evidence surrounding chelation therapy in acute copper poisoning. We describe a case of a patient who clinically improved while receiving aggressive supportive care and associated succimer monotherapy after acute ingestion of a copper compound.

Abstract licence: CC BY