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Dimercaprol
From WikEM
(Redirected from BAL)
Contents
Administration
- Type: Chelator, Antidote
- Dosage Forms:
- Routes of Administration: IM
- Common Trade Names: British antilewisite (BAL)
Adult Dosing
- Arsenic or gold toxicity, mild: 2.5 mg/kg IM 4 times per day x 2 days, BID on day 3, then daily x 10 days
- Arsenic or gold toxicity, severe: 3 mg/kg IM q4 hours x 2 days, 4 times on day 3, then BID x 10 days
- Mercury toxicity: 5mg/kg IM on day 1, then 2.5 mg/kg 1-2 times daily x 10 days
- Lead poisoning, mild: 4 mg/kg IM for initial dose, then 3 mg/kg q4 hourr for 2-7 days in combination with edetate calcium disodium (EDTA)
- Lead poisoning, severe: 4 mg/kg IM every 4 hr for 2-7 days in combination with edetate calcium disodium (EDTA)
Pediatric Dosing
- Same as above
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: use at reduced dose and with caution
- Hepatic dosing: contraindicated in hepatic insufficiency
Contraindications
- Allergy to class/drug
- Hepatic insufficiency (unless due to arsenic)
Adverse Reactions
Serious
- Tachycardia, hypertension
- Fever
Common
- Fever
- Bronchospasm, chest tightness
- Headache, paresthesias, tremor
- Blepharospasm, conjunctivitis
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of Action
- Binds thiol group on heavy metals, preventing those groups from binding/inhibiting enzymes and allowing urinary excretion of metals
