Module 27.2 - Heavy Metal Toxicology - Podcast

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Welcome to this intensive toxicology training module! Understanding heavy metal and elemental poisoning is paramount in acute care, and this session provides comprehensive insights into six crucial substances: Antimony (Sb), Arsenic (As), Cobalt (Co), Mercury (Hg), Thallium (Tl), and Zinc (Zn).
We break down the complexities of toxicokinetics and pathophysiology, exploring how trivalent arsenic inhibits the pyruvate dehydrogenase (PDH) complex and how thallium precisely mimics potassium (K⁺) ions. Learn to recognize the distinct, multisystemic clinical presentations—from arsenic's classic spotted hyperpigmentation to thallium's triad of gastroenteritis, polyneuropathy, and alopecia. We also cover the consequences of chronic zinc toxicity, which centrally results in copper deficiency, manifesting as sideroblastic anemia and progressive myeloneuropathy ("Zinc swayback").
Crucially, we differentiate management strategies:
Chelation Therapy: Application is nuanced. Learn when to use agents like DMSA, DMPS, and CaNa₂EDTA for antimony, arsenic, cobalt, and inorganic mercury, and why Dimercaprol (BAL) is contraindicated in organic mercury and elemental mercury vapor exposure.
Enhanced Elimination: Discover the unique role of Prussian Blue in facilitating thallium excretion.
Elemental Phosphorus: Remember this is a highly toxic non-metal requiring aggressive supportive care and decontamination (like cold water for burns), as there is no specific antidote or chelating agent.
This content is essential for equipping healthcare professionals with the knowledge needed for prompt diagnosis and effective intervention in elemental and heavy metal toxicities.