Metal antagonists

Klaassen C. D. (1996). Heavy metals and heavy-metal antagonists. Chapter in Hardman, J. G., Limbird, L. E., Molinoff, P. B., Ruddon, R. W. Gilman, A. G. (eds) Goodman Gilman s The Pharmacological Basis of Therapeutics, 9th edn. McGraw-Hill, New York, pp. 1649-1671. 

Mechanism of Action A heavy metal antagonist that chelates copper, iron, mercury, lead to form complexes, promoting excretion of copper. Combines with cystine-forming complex, thus reducing concentration of cystine to below levels for formation of cystine stones. Exact mechanism for rheumatoid arthritis is unknown. May decrease cell-mediated immune response. May inhibit collagen formation. Therapeutic Effect Promotes excretion of copper, prevents renal calculi, dissolves existing stones, acts as anti-inflammatory drug. 

Klaassen CD. Heavy metals and heavy-metal antagonists. In HardmanJG, et al, eds. The Pharmacological Basis of Therapeutics. 10th ed. New York McGraw-Hill 2001. 

Edetate disodium, a heavy metal antagonist, is indicated in hypercalcemia (500 mg/kg daily by slow IV infusion) and in digitalis-induced cardiac arrhythmias (15 mg/kg/hour by IV infusion). Ethylenediaminetetraacetic acid (EDTA) will lower serum levels of calcium, magnesium, and zinc. It should not be used in anuria, and renal excretory functions (BUN and creatinine) should be monitored carefully. EDTA should be used cautiously in hypokalemia and in patients with limited cardiac reserve. 

CHAPTER 65 Heavy Metals and Heavy-Metal Antagonists... 

Meyboom RHB (1975) Heavy metal antagonists. In Dukes MNG (ed) Meyler s side effects of drugs, 8. Excerpta Medica, Amsterdam London New York, pp 529-542 Mihas AA, Goldenberg DJ, Slaughter RL (1978) Sulfasalazine toxic reactions. Hepatitis, fever and skin rash with hypocomplementemia and immune complexes. JAMA 239 2590-2591... 

TABLE 1 Comparison 23. METAL ANTAGONISTS of Three Commonly Prescribed Iron Chelators Deferoxamine, Deferiprone. and Deferasirox ... 

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