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Mechanism of Action: Forms a chelate by binding sulfhydryl groups with arsenic, mercury, lead, and gold, thus increasing both urinary and fecal excretion of the metals Indications: Acute arsenic, mercury, and gold poisoning With EDTA in acute lead poisoning Not effective for chronic mercury poisoning Contraindications: Iron, cadmium, silver, uranium, or selenium poisoning Hepatic or renal insufficiency, except postarsenical jaundice Use during pregnancy only if poisoning is life-threatening Side Effects: Most common side effects include hypertension and tachycardia (dose dependent) Pharmacokinetics: Administered deep IM only To be fully effective, administer 1-2 hr after exposure Peak plasma concentration: IM, 30-60 min Mostly distributed to extracellular fluid Time to peak levels: 30-60 min Rapidly metabolized to inactive product and completely excreted in urine and feces in 4 hr References: Olson KR (2007): Poisoning & Drug Overdose
