2, 3-Dimercaprol DMPS

British antilewisite (BAL[2,3-dimercaptopropanol]), dimercaprol DMPS (2,3-dimercapto-l-propanesulfonic acid)... 

There is limited evidence to recommend combined chelation and blood purification therapy for other heavy metal poisonings, such as copper, mercury, arsenic, and thalhum. There are case reports, however, outlining several such attempts. Treatment of cupric sulfate ingestion by dimercaprol and penicillamine chelation followed by hemoperfusion and hemodia-filtration has been reported [57]. An interesting case of inorganic mercury poisoning treated with DMPS chelation and continuous venous-venous hemodiafiltration (CVVHDF) was also reported [58]. It should be noted that treatment continued for 14 days with a hmited total removal of mercury (<13% of the ingested dose) in... 

In acute exposure prompt medical attention is critical. The victim should be immediately removed to fresh air and away from the source of exposure. Oxygen should be provided if there is a respiratory distress. Initial therapy should be directed at stopping the ongoing hemolysis by performing exchange transfusion. Currently there is no other treatment to decrease arsine hemolysis however, studies in vitro have shown that some dithiol chelators (meso-2,3-dimercaptosuccinic acid, DMSA 2,3-dimercapto-l-propanesulfonic acid, DMPS and 2,3-butanedithiol) are effective (see Further Reading). This should be followed by aims to restore renal function or compensate for lost renal function (hemodialysis). This process does not remove any formed arsenic from the exposed body. Administration of dimercaprol (British Anti-Lewisite, BAL) has no effect on arsine hemolysis, but it lowers blood arsenic levels resulting from arsine exposure. The use of chelators must be... 

DMPS and DMSA can be used to increase Hg excretion. Dimercaprol (BAL), used in the past for chelation, is contraindicated because it redistributes Hg to the brain. 

Two water-soluble analogs of dimercaprol have been studied as lewisite antidotes, namely meio-2,3-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto- 1-propane sulfonic acid (DMPS) (see review by Aposhian, 1993). Their structures are as follows ... 

DMPS and DMSA applied to the skin would probably be of value in lewisite-induced vesication. However, the disadvantages of dimercaprol largely relate to systemic treatment and the water-soluble analogues are unlikely to be better than dimercaprol ointment. 

Section II Arsenic Arsine Lead Mercury Section III BAL (Dimercaprol) EDTA, Calcium (Calcium Disodium EDTA, Calcium Disodium Edetate, Calcium Disodium Versenate) Succimer (DMSA) Unithiol (DMPS)... 

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