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Questions and Answers
What is the primary therapeutic use of fluoride?
What effect does lithium have on sodium levels in the body?
What is a common side effect of excessive bromide intake?
What is the treatment for bromism?
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Which of the following ions is considered a non-essential ion but has therapeutic uses?
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What is a potential consequence of decreased sodium intake in lithium treatment?
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What is the significance of fluoride in relation to osteoporosis?
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What method is used to determine the potential toxicity of uric acid in guinea pigs?
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What is the primary reason for discontinuing lithium carbonate treatment in manic patients?
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Which condition contraindicates the use of lithium carbonate?
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How does lithium carbonate affect thyroid function?
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What is the mechanism by which lithium carbonate works during a manic episode?
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What type of therapy is gold primarily used for?
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What is a significant risk factor for gold toxicity?
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How does gold manage symptoms in rheumatoid arthritis?
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In which condition is gold contraindicated?
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What is the usual dosage range for aurothioglucose injection?
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What type of action do soluble aluminum compounds primarily have in cosmetics?
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What is argyria, and what causes its development?
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What is the main treatment for barium poisoning?
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Which of the following is a characteristic of silver as a medical compound?
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What are the gastrointestinal effects of barium cation toxicity?
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What is the main concern when using barium chloride as a stimulant?
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What are the primary sources of lead poisoning in modern environments?
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What is one common treatment method for acute mercury poisoning?
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Which chelating agent has been recommended as superior in treating chronic mercury poisoning?
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What potential effect does chronic mercury poisoning have on the central nervous system?
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What is a disadvantage of organic mercurial diuretics mentioned?
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Which of the following is NOT a use for mercurial salts?
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Which type of lead can penetrate intact skin?
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What is the primary organ that accumulates lead over time?
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What serious health issue is most commonly associated with lead poisoning in children?
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What initial treatment is recommended for acute lead poisoning from oral ingestion?
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Which chelating agent is used for follow-up treatment of chronic lead poisoning?
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Which mercury compound is considered the most toxic?
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Mercuric cation primarily concentrates in which organ after absorption?
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What mechanism does lead employ to cause toxicity?
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Study Notes
Fluoride
- Fluoride is an essential ion for bone health and dental health
- Fluoride is most commonly used for its anticariogenic properties, preventing tooth decay
- Oral fluoride is absorbed from the gut, with the majority excreted in the urine
- Sodium fluoride has a wide therapeutic dosage index, meaning it is generally safe for oral health
- Many reports show that fluoride can reduce the prevalence of osteoporosis, but too low fluoride levels may lead to increased aortic calcification
- Fluoride facilitates calcium deposition in hard tissues, like teeth and bones, rather than soft tissues
Bromide
- Bromides are a class of compounds historically used for their antiepileptic effects.
- Small doses of bromide can cause depression of the central nervous system (CNS).
- Large doses of bromide can depress all reflexes and lead to narcotic-like effects.
- The usefulness of bromides in epilepsy is due to their ability to depress the motor areas of the brain.
- Bromides are absorbed quickly and primarily excreted in the urine.
- Repeated bromide doses can accumulate in the body, leading to the possible replacement of chloride ions with bromide ions.
- This accumulation can cause bromism, also known as bromide poisoning.
- Treatment for bromism involves sodium chloride administration to help the body excrete bromide.
Lithium
- Lithium is an ion absorbed readily from the intestines and accumulates in the body.
- Lithium accumulation is influenced by sodium intake, with low sodium levels leading to increased lithium accumulation and potential toxicity.
- Lithium intoxication is treated by withholding lithium and increasing sodium intake.
- Lithium acts as a CNS depressant and has diuretic effects.
- Lithium salts once had use cases as central nervous system depressants.
- Lithium carbonate is used for its effect on manic depressive disorder.
- Lithium carbonate medication is administered orally.
- Contraindications for lithium carbonate include individuals with impaired renal function or those on a salt-restricted diet or diuretics.
- Lithium carbonate can affect thyroid function, potentially causing myxoedema.
- Lithium can reduce atherosclerotic heart disease.
Gold
- Gold is a heavy metal used for its pharmacological properties.
- Gold compounds are administered intramuscularly due to poor oral absorption.
- Gold is primarily used in the treatment of rheumatoid arthritis, where it acts by stabilizing lysosomal membranes, reducing enzymatic breakdown of joint tissues.
- It is thought that gold mainly provides symptomatic relief.
- Gold can also be used in the treatment of non-disseminated lupus erythematosus.
- It should be avoided for individuals with renal disease, a history of hepatitis, skin or blood disorders, diabetes, pregnancy, hypertension, or congestive heart failure.
Aluminum
- Soluble aluminum compounds are astringent and antiseptic.
- Soluble aluminum salts are widely used in the cosmetic industry as deodorants.
- Insoluble aluminum compounds are used as non-systemic antacids.
Silver
- Silver is a protein precipitant.
- Silver ions have various effects on tissues ranging from antiseptic and astringent to corrosive.
- Silver preparations are used topically for their antiseptic properties.
- Prolonged use of silver preparations can lead to argyria, which is the discoloration of the skin.
- This discoloration is often caused by silver sulfide or reduced silver.
Barium
- Barium cations are systemically toxic due to their muscle-stimulating action.
- Barium poisoning can cause vomiting, severe colic, diarrhea, hemorrhage, and ultimately death.
- Treatment for barium poisoning involves administering sodium or magnesium sulfate to precipitate insoluble barium sulfate in the gastrointestinal tract, followed by gastric lavage.
- Barium sulfate, because of its insolubility, is used as a radiopaque contrast agent in X-ray studies of the gastrointestinal tract.
Lead
- Lead poisoning is now largely sourced from industrial and automobile fumes.
- Lead salts were historically used topically as an astringent.
- Lead is slowly absorbed orally and excreted reasonably well.
- Inorganic lead cannot penetrate intact skin but can be absorbed through abraded skin.
- Organic lead, like tetraethyl lead, can penetrate intact skin rapidly.
- After absorption, lead often initially accumulates in erythrocytes and soft tissues, later shifting to the kidneys, liver, and eventually bones, teeth, and hair.
- Lead deposited in the bone is considered non-toxic until remobilized.
- Lead poisoning can manifest as inhibition of heme synthesis, leading to anemia.
- The most serious lead poisoning symptom is encephalopathy, which can cause brain damage, seizures, and mental retardation.
- Lead poisoning can also cause renal damage.
- Treatment for lead poisoning involves using chelating agents to remove accumulated lead.
- Dimercaprol and calcium disodium edetate are used initially, followed by pencillamine for follow-up treatment.
- Acute oral lead poisoning treatment involves administering sodium or magnesium sulfate to precipitate lead, followed by gastric lavage.
Mercury
- Metallic mercury is relatively non-toxic compared to its mercurous Hg+ and mercuric Hg+2 cations.
- Mercury vapor is also toxic.
- Poisoning by soluble inorganic mercury salts can be avoided by adhering to strict dosage schedules.
- Organic mercurial compounds, such as alkylated mercurials, are highly toxic.
- Similar to lead, mercury combines with protein sulfhydryl groups, leading to its toxic effects.
- After absorption, the mercuric cation concentrates mainly in the kidneys, with lower levels in the liver, blood, bone marrow, and other tissues.
- Mercury is primarily excreted by the kidneys and colon.
- Acute mercury poisoning can lead to vomiting, diarrhea, and kidney damage.
- Treatment for acute poisoning includes gastric lavage, using reducing agents to convert mercuric cation into less soluble mercurous salts, and administering chelating agents like dimercaprol or pencillamine.
- Chronic mercury poisoning can result from industrial exposure, food contamination, and long-term topical exposure.
- Chronic mercury exposure affects the CNS, leading to behavioral changes, tremors, insomnia, and ataxia.
- Chronic mercury poisoning is more difficult to treat than acute poisoning and involves removing the source of mercury, administering chelating agents, and providing supportive care.
- Mercurial salts are used as diuretics, antiseptics, parasiticides, and fungicides.
- Mercurial diuretics act by inactivating specific enzymes in the renal tubules, leading to sodium and water diuresis.
- Organic mercurial diuretics have poor absorption from the gut and must be administered parenterally.
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Description
This quiz covers essential information about fluoride and bromide, focusing on their effects on health and medical applications. Discover how fluoride supports bone and dental health while understanding the historical use of bromide in treating epilepsy and its effects on the central nervous system.
