Dimercaprol
Clinical data | |
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Trade names | BAL in Oil |
Other names | 2,3-Dimercaptopropanol British Anti-Lewisite 2,3-Dithiopropanol 2,3-Dimercaptopropan-1-ol British antilewisite |
AHFS/Drugs.com | Monograph |
License data |
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Routes of administration | intramuscular |
ATC code | |
Legal status | |
Legal status |
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Pharmacokinetic data | |
Excretion | Urine[1] |
Identifiers | |
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JSmol) | |
Density | 1.239 g cm−3 g/cm3 |
Boiling point | 393 °C (739 °F) at 2.0 kPa |
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Dimercaprol, also called British anti-Lewisite (BAL), is a
Common side effects include
Dimercaprol was first made during World War II.[5] It is on the World Health Organization's List of Essential Medicines.[6]
Medical uses
Dimercaprol has long been the mainstay of chelation therapy for lead or arsenic poisoning,[7] and it is an essential drug.[6] It is also used as an antidote to the chemical weapon Lewisite. Nonetheless, because it can have serious adverse effects, researchers have also pursued development of less toxic analogues,[7] such as succimer.
Wilson's disease is a genetic disorder in which copper builds up inside the liver and other tissues. Dimercaprol is a copper chelating agent that has been approved by the FDA to treat Wilson's disease.[8]
Dimercaprol also shows effectiveness against snakebite by potently antagonizing the activity of Zn2+-dependent snake venom metalloproteinases in vitro.[9]
Mechanism of action
Dimercaprol is itself toxic, with a narrow therapeutic range and a tendency to concentrate arsenic in some organs. Other drawbacks include the need to administer it by painful intramuscular injection[11] Serious side effects include nephrotoxicity and hypertension.
Dimercaprol has been found to form stable chelates in vivo with many other metals including inorganic mercury, antimony, bismuth, cadmium, chromium, cobalt, gold, and nickel. However, it is not necessarily the treatment of choice for toxicity to these metals. Dimercaprol has been used as an adjunct in the treatment of the acute encephalopathy of lead toxicity. It is a potentially toxic drug, and its use may be accompanied by multiple side effects. Although treatment with dimercaprol will increase the excretion of cadmium, there is a concomitant increase in renal cadmium concentration, so that its use in case of cadmium toxicity is to be avoided. It does, however, remove inorganic mercury from the kidneys; but is not useful in the treatment of alkylmercury or phenylmercury toxicity. Dimercaprol also enhances the toxicity of selenium and tellurium, so it is not to be used to remove these elements from the body.[citation needed]
History
The original name of dimercaprol reflects its origins as a
See also
- 2,3-Dimercapto-1-propanesulfonic acid
- Dimercaptosuccinic acid
- DMSA scan
- EDTA
- Heavy metal poisoning
- Penicillamine
References
- ISBN 978-93-5025-773-9.
- ISBN 978-0-85404-182-4.
The prefixes 'mercapto' (–SH), and 'hydroseleno' or selenyl (–SeH), etc. are no longer recommended.
- ^ a b c d e f g "Dimercaprol". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
- ISBN 978-92-4-154765-9.
- ISBN 978-0-19-953484-5. Archivedfrom the original on 2016-12-20.
- ^ hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ PMID 20717537.
- S2CID 26059921.
- PMID 32376771.
- PMID 2692088.
- S2CID 44772701.
- ^ a b Tabangcura Jr D, Daubert GP. "British anti-Lewisite". Archived from the original on 2009-02-02.
- S2CID 4129186.
External links
- "Dimercaprol". Drug Information Portal. U.S. National Library of Medicine.