CBS colloidal bismuth

CBS = colloidal bismuth subcitrate RBC = ranitidine bismuth citrate approximate formulas. 

Widespread medicinal use of colloidal bismuth subcitrate (CBS) has prompted extensive studies of bismuth compounds involving the citrate anion. Bismuth citrate is essentially insoluble in water, but a dramatic increase in solubility with increasing pH has been exploited as a bio-ready source of soluble bismuth, a material referred to as CBS. Formulation of these solutions is complicated by the variability of the bismuth anion stoichiometry, the presence of potassium and/ or ammonium cations, the susceptibility of bismuth to oxygenation to Bi=0, and the incorporation of water in isolated solids. Consequently, a variety of formulas are classified in the literature as CBS. Solids isolated from various, often ill-defined combinations of bismuth citrate, citric acid, potassium hydroxide, or ammonium hydroxide have been assigned formulas on the basis of elemental analysis data or by determination of water and ammonia content, but are of low significance in the absence of complementary data other than thermal analysis (163), infrared spectroscopy (163), or NMR spectroscopy (164). In this context, the Merck index lists the chemical formula of CBS as KgfNHJaBieOafOHMCeHsCbh in the 11th edition (165), but in the most recent edition provides a less precise name, tripotassium dicitrato bismuthate (166). 

Inductively coupled plasma-mass spectrometry (ICP-MS) is a modern and more sensitive variation of MS detection of bismuth. Bismuthine is generated in a hydride generator and swept by argon directly into the ICP unit. The ions are then introduced into the mass spectrometer. Optimization of the mass spectrometer, reagent, and gas flow parameters leads to a detection limit of 20ngL (IfQand 1993). Phillips etal. (2001) examined the safety aspects of colloidal bismuth subcitrate (CBS) quadruple therapy for Helicobacter pylori. These authors used ICP-MS to determine blood Bi levels in 34 patients receiving CBS quadruple therapy, with whole blood Bi levels being deter-... 

Interestingly, all of the elements in group 15 in the periodic table (N, P, As, Sb and Bi) are directly or indirectly related to the maintenance of human life as either essential elements (e.g., N and P) or therapeutic/toxic elements (e.g.. As, Sb and Bi). Currently antimony compounds (e.g., sodium stibogluconate, Pentostam ) are used clinically for the treatment of leishmaniasis and bismuth compounds (e.g., bismuth subsalicylate (BSS), colloidal bismuth subcitrate (CBS) and ranitidine bismuth citrate (RBC)) are widely used for the treatment of ulcer and Helicobacter pylori infection [l-3c,10,132,133]. Recently, clinical... 

Scheme 5.7 The basic BP citrate dimer found in the antiulcer drugs, colloidal bismuth subcitrate (CBS, DE-Nol ) and possibly ranitidine bismuth citrate. Assembly of these building block leads to the formation of polymeric anion.

Asato E, Katsura K, Mikuriya M, Fujii T, Reedijk J (1993) Synthesis structure, and spectroscopic characterization of bismuth citrate compounds and bismuth-containing ulcer healing agent colloidal bismuth subcitrate (CBS). 3. Crystal and solution structures of KNH4[Bij(cit)j(H20)2] (HjO) (x=2,4). Inorg Chem 32 5322-5329... 

---