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Chỉ định và Liều dùng
Intramuscular
Heavy metal poisoning Adult: 400-800 mg on the 1st day followed by 200-400 mg on the 2nd and 3rd day, then 100-200 mg on the 4th and subsequent days, all in divided doses. Intramuscular Adjunct in lead poisoning Adult: In conjunction w/ sodium calcium edetate: Initially, 4 mg/kg followed by 3-4 mg/kg at 4-hrly intervals. Maintenance: 2-7 days.
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Suy gan
Contraindicated.
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Chống chỉ định
Hepatic impairment. Concomitant use w/ Fe, cadmium, uranium or selenium.
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Thận trọng
Patient w/ HTN, oliguria, G6PD deficiency, peanut allergy. Renal impairment. Pregnancy and lactation.
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Tác dụng không mong muốn
Tachycardia, HTN, nausea, vomiting, headache, burning sensation of the lips, mouth, throat, eyes and penis, salivation, lacrimation, tingling of the extremities, sensation of throat and chest constriction, sweating, conjunctivitis, muscle pains and spasm, rhinorrhoea, anxiety, abdominal pain, weakness, pain at the inj site, sterile abscess.
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IM/Parenteral: C
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Chỉ số theo dõi
Monitor urine pH, renal function, infusion-related reactions, blood levels, Hb or haematocrit, Fe status.
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Quá liều
Symptoms: Nausea, vomiting, malaise, lacrimation, salivation; burning sensation of lips, throat, mouth and eyes w/ headache; sense of throat and chest constriction; increased BP. Management: Admin SC diphenhydramine 50 mg or ephedrine 30 mg, or oral ephedrine 30-60 mg.
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Tương tác
Potentially Fatal: May form toxic complexes w/ Fe supplements, cadmium, selenium, uranium.
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Ảnh hưởng đến kết quả xét nghiệm
Interferes w/ normal accumulation of iodine by the thyroid. Decreased iodine I 131 thyroidal uptake values.
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Tác dụng
Description:
Mechanism of Action: Dimercaprol chelates heavy metals e.g. gold, arsenic, mercury by competing w/ endogenous sulfhydryl groups on enzymes. This chelation prevents or reverses any inhibition of the sulfhydryl enzymes by the metal and forms a complex readily secreted in the kidneys. Pharmacokinetics: Absorption: Rapidly absorbed. Time to peak plasma concentration: 30-60 min. Distribution: Widely distributed to all tissues including the brain, w/ the highest concentrations in the liver and kidneys. Metabolism: Undergoes rapid hepatic metabolism and converted to inactive metabolites. Excretion: Via urine and bile. Essentially complete elimination w/in 4 hr of a single dose. |
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Đặc tính
 Source: National Center for Biotechnology Information. PubChem Database. Dimercaprol, CID=3080, https://pubchem.ncbi.nlm.nih.gov/compound/Dimercaprol (accessed on Jan. 21, 2020) |
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Bảo quản
Store between 20-25°C.
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Phân loại MIMS
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Phân loại ATC
V03AB09 - dimercaprol ; Belongs to the class of antidotes. Used in the management of heavy metals poisoning.
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Tài liệu tham khảo
Anon. Dimercaprol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 19/01/2016. BAL – Dimercaprol Injection (Akorn, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 19/01/2016. Buckingham R (ed). Dimercaprol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/01/2016. McEvoy GK, Snow EK, Miller J et al (eds). Dimercaprol. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 19/01/2016.
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