Elemental Mercury Poisoning—Acute

Binds to sulfide groups, blocking sulfhydril enzymes, disrupting cellular metabolism 

Arterial pressure - increased Bowel movements - diarrhea Breathing - diff, acute (acute dyspnea) Chest - pain Chills 

Heart rate - increased (tachycardia) Mentation - coma Mentation - confusion Mentation - weakness (malaise) 

Mood - lethargic Mouth, gingiva - inflammed Mouth - burning Nausea 

Sense of taste - metallic Skin - rash, erythematous Skin - rash, vesicular Vomiting 

---

Metallic (elemental) mercury. In acute or chronic poisoning, oral suc-cimer (DMSA, p 501) or oral unithiol (DMPS, p 506) may enhance urinary Hg excretion (although its effect on clinical outcome has not been fully studied). Although penicillamine (p 484) Is an alternative oral treatment. It may be associated with more side effects and less efficient Hg excretion. 

E. Redistribution of metals to the brain. Despite its capacity to increase survival in acutely poisoned animals, BAL has been associated with redistribution of mercury and arsenic into the brain. Avoid use in chronic elemental mercury poisoning or alkyl (eg, methyl) mercury poisoning, where the brain is a key target organ. 

Dimercaprol is FDA-approved as single-agent treatment of acute poisoning by arsenic and inorganic or elemental mercury and for the treatment of severe lead poisoning when used in conjunction with edetate calcium disodium (EDTA see below). Although studies of its metabolism in humans are limited, intramuscularly administered dimercaprol appears to be readily absorbed, metabolized, and excreted by the kidney within 4-8 hours. Animal models indicate that it may also undergo biliary excretion, but the role of this excretory route in humans and other details of its biotransformation are uncertain. 

Taueg C, Sanfilippo DJ, Rowens B, et al. 1992. Acute and chronic poisoning from residential exposures to elemental mercury. J Toxicol Clin Toxicol 30(l) 63-67. 

Mercury poisoning may be acute or chronic and is related to exposure to elemental mercury vapour, inorganic salts or organic forms such as methyl-mercury. Metallic mercury is relatively non-toxic if ingested, hut mercury vapour can give rise to acute toxicity. The symptoms are respiratory distress and a metallic taste in the mouth. 

---