Lewisite poisoning

Cyanide poisoning Ethylene glycol poisoning Hantavirus pulmonary syndrome Hemorrhagic fever with renal syndrome Lewisite poisoning Malaria... 

Ebola hemorrhagic fever, 67-71 Influenza, 100-103 Lassa fever, 104-108 Leptospirosis, 114-119 Lewisite poisoning, 342-345... 

The severity of lewisite poisoning depends upon the mode, duration and concentration of exposure. Its effects are worsened by hot, humid conditions and are described in Table 5.22. Systemic features includes those of arsenic poisoning (p. 276, Table 5.14). 

Some animal studies have suggested advantages to the use of dimercapto-propane sulfonate (DMPS) or dimercaptosuccinic acid (DMSA) following systemic lewisite poisoning. Toxbase includes further guidance. 

Dimercaprol (British Anti-Lewisite or BAL) is a colorless, viscous oily compound with an offensive odor used in treating arsenic, mercury, and gold poisoning. It displaces the arsenic bound to enzymes. The enzymes are reactivated and can resume their normal biological activity. When given by injection, BAL can lead to alarming reactions that seem to pass in a few hours. 

In pure liquid form, lewisite causes blindness, immediate destruction of lung tissue, and systemic blood poisoning. It is absorbed through the skin like distilled mustard, but is much more toxic to the skin. Skin exposure results in immediate pain a rash forms within 30 minutes. Severe chemical burns are possible. Blistering of the skin takes up to 13 hours to develop. Lewisite does not dissolve in human sweat. It commingles with sweat, then flows to tender skin areas such as the inner arm, buttocks, and crotch. 

The first chelating agent developed as an antidote to a heavy metal poison was 2,3-dimereaptopropanol (dimercaprol, British Anti-Lewisite, BAL). Originally intended for use on victims of the arsenical vesicant poison gas Lewisite52, it has since proved efficacious in the treatment of antimony, gold and mercury poisoning as well as... 

Another compound used to treat lead poisoning is British anti-Lewisite (BAL), originally developed to treat arsenic-containing poison gas Lewisite. As shown in Figure 10.6, BAL chelates lead through its sulfhydryl groups, and the chelate is excreted through the kidney and bile. 

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