Dimercaprol Injection

DIMEVIT Injection, also known as British Anti-Lewisite (BAL), is a chelating agent used primarily for the treatment of heavy metal poisoning. Here are the primary uses and related information:

 Primary Uses

 1. Arsenic Poisoning

- Purpose: Used to treat acute arsenic poisoning by binding to arsenic ions and forming a stable complex that can be excreted from the body.

 2. Lead Poisoning

- Purpose: Administered in cases of acute lead poisoning, often in combination with other chelating agents such as calcium disodium edetate (CaNa2EDTA).

 3. Mercury Poisoning

- Purpose: Effective in treating acute mercury poisoning by binding to mercury and facilitating its excretion from the body.

 4. Gold Poisoning

- Purpose: Used to treat gold poisoning, which can occur from therapeutic use of gold compounds in conditions like rheumatoid arthritis.

 Mechanism of Action

Dimercaprol works by binding to heavy metal ions through its sulfhydryl (“SH) groups, forming a stable, non-toxic, water-soluble complex that can be excreted by the kidneys. This chelation process helps to reduce the concentration of free heavy metal ions in the body, thereby mitigating their toxic effects.

 Administration

- Intramuscular (IM) Injection: Administered via intramuscular injection. The dosage and frequency depend on the severity of poisoning and the specific heavy metal involved.

 Side Effects

- Common: Pain at the injection site, fever, hypertension, tachycardia, nausea, vomiting, headache, and a metallic taste in the mouth.

- Serious: Nephrotoxicity, hepatotoxicity, hemolysis (especially in patients with glucose-6-phosphate dehydrogenase deficiency), and allergic reactions.

 Precautions

- Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency: Use with caution in patients with G6PD deficiency due to the risk of hemolysis.

- Hepatic and Renal Impairment: Monitor liver and kidney function during treatment, as dimercaprol can be hepatotoxic and nephrotoxic.

- Allergic Reactions: Monitor for signs of allergic reactions and discontinue use if severe reactions occur.

 Interactions

- Iron Supplements: Avoid concomitant use with iron supplements, as dimercaprol can enhance the toxicity of iron.

- Other Chelating Agents: Use caution when administering with other chelating agents to avoid potential interactions and increased toxicity.

 Conclusion

Dimercaprol Injection is an effective treatment for acute poisoning by heavy metals such as arsenic, lead, mercury, and gold. Its chelating properties help to neutralize and facilitate the excretion of toxic metal ions from the body. Proper administration, monitoring for side effects, and consideration of patient-specific factors are essential to ensure safe and effective use.