Prussian blue (medical use)

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Prussian blue
Pigment Berliner Blau.JPG
Prussian blue
Clinical data
Trade names Radiogardase, others
AHFS/Drugs.com Monograph
Routes of
administration
by mouth
ATC code
Identifiers
CAS Number
PubChem CID
ChemSpider
UNII
Chemical and physical data
Formula C18Fe7N18
Molar mass 859.24

Prussian blue, also known as potassium ferric hexacyanoferrate, is used as a medication to treat thallium poisoning or radioactive caesium poisoning. [1] [2] For thallium it may be used in addition to gastric lavage, activated charcoal, forced diuresis, and hemodialysis. [3] [4] It is given by mouth or nasogastric tube. [2] [4] Prussian blue is also used in the urine to test for G6PD deficiency. [5]

Contents

Side effects may include constipation, low blood potassium, and stools that are dark. [1] [3] With long-term use, sweat may turn blue. [3] It mainly works by trapping the toxic monovalent cations in its crystal lattice after ion-exchange with potassium or ammonium cations and thus preventing the absorption of thallium and radio-caesium from the intestines. [3]

Prussian blue was developed around 1706. [6] It is on the World Health Organization's List of Essential Medicines. [7] As of 2016, it is only approved for medical use in Germany, the United States, and Japan. [8] [9] [10] Access to medical-grade Prussian blue can be difficult in many areas of the world including the developed world. [11]

Medical uses

Prussian blue is used to treat thallium poisoning or radioactive caesium poisoning. [1] [2] [12] It may also be used for exposure to radioactive material until the underlying type is determined. [3] [ clarification needed ]

Often it is given with mannitol or sorbitol to increase the speed it moves through the intestines. [4]

Prussian blue is also used to detect hemosiderin in urine to confirm a diagnosis of G6PD deficiency. [5]

Thallium poisoning

For thallium it may be used in addition to gastric lavage, forced diuresis, and hemodialysis. [3]

It is given until the amount of thallium in the urine drops to below 0.5 mg per day. [4]

Caesium poisoning

It is specifically only used for radioactive caesium poisoning when the caesium has entered the body either by swallowing or breathing it in. [4]

Related Research Articles

<span class="mw-page-title-main">Thallium</span> Chemical element, symbol Tl and atomic number 81

Thallium is a chemical element; it has symbol Tl and atomic number 81. It is a gray post-transition metal that is not found free in nature. When isolated, thallium resembles tin, but discolors when exposed to air. Chemists William Crookes and Claude-Auguste Lamy discovered thallium independently in 1861, in residues of sulfuric acid production. Both used the newly developed method of flame spectroscopy, in which thallium produces a notable green spectral line. Thallium, from Greek θαλλός, thallós, meaning "green shoot" or "twig", was named by Crookes. It was isolated by both Lamy and Crookes in 1862; Lamy by electrolysis, and Crookes by precipitation and melting of the resultant powder. Crookes exhibited it as a powder precipitated by zinc at the international exhibition, which opened on 1 May that year.

<span class="mw-page-title-main">Poison</span> Substance that causes death, injury or harm to organs

A poison is any chemical substance that is harmful or lethal to living organisms. The term is used in a wide range of scientific fields and industries, where it is often specifically defined. It may also be applied colloquially or figuratively, with a broad sense.

<span class="mw-page-title-main">Prussian blue</span> Synthetic pigment

Prussian blue is a dark blue pigment produced by oxidation of ferrous ferrocyanide salts. It has the chemical formula FeIII
4
[FeII
(CN)
6
]
3
. Turnbull's blue is chemically identical, but is made from different reagents, and its slightly different color stems from different impurities and particle sizes.

Diuresis is the excretion of urine, especially when excessive (polyuria). The term collectively denotes the physiologic processes underpinning increased urine production by the kidneys during maintenance of fluid balance.

<span class="mw-page-title-main">Pesticide poisoning</span> Poisoning of humans from pesticide exposure

A pesticide poisoning occurs when pesticides, chemicals intended to control a pest, affect non-target organisms such as humans, wildlife, plants, or bees. There are three types of pesticide poisoning. The first of the three is a single and short-term very high level of exposure which can be experienced by individuals who commit suicide, as well as pesticide formulators. The second type of poisoning is long-term high-level exposure, which can occur in pesticide formulators and manufacturers. The third type of poisoning is a long-term low-level exposure, which individuals are exposed to from sources such as pesticide residues in food as well as contact with pesticide residues in the air, water, soil, sediment, food materials, plants and animals.

<span class="mw-page-title-main">Furosemide</span> Loop diuretic medication

Furosemide is a loop diuretic medication used to treat edema due to heart failure, liver scarring, or kidney disease. It has had many trade names including Discoid, Frusemide, Lasix and Uremide. Furosemide may also be used for the treatment of high blood pressure. It can be taken intravenously or orally. When given intravenously, furosemide typically takes effect within five minutes; when taken orally, it typically metabolizes within an hour.

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<span class="mw-page-title-main">Dimercaprol</span> Chemical compound

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Amiloride, sold under the trade name Midamor among others, is a medication typically used with other medications to treat high blood pressure or swelling due to heart failure or cirrhosis of the liver. Amiloride is classified as a potassium-sparing diuretic. Amiloride is often used together with another diuretic, such as a thiazide or loop diuretic. It is taken by mouth. Onset of action is about two hours and it lasts for about a day.

Gastric lavage, also commonly called stomach pumping or gastric irrigation, is the process of cleaning out the contents of the stomach using a tube. Since its first recorded use in early 19th century, it has become one of the most routine means of eliminating poisons from the stomach. Such devices are normally used on a person who has ingested a poison or overdosed on a drug such as ethanol. They may also be used before surgery, to clear the contents of the digestive tract before it is opened.

<span class="mw-page-title-main">Whole bowel irrigation</span> Medical process

Whole bowel irrigation (WBI) is a medical process involving the rapid administration of large volumes of an osmotically balanced macrogol solution, either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.

<span class="mw-page-title-main">Hydroxocobalamin</span> Form of vitamin B12

Hydroxocobalamin, also known as vitamin B12a and hydroxycobalamin, is a vitamin found in food and used as a dietary supplement. As a supplement it is used to treat vitamin B12 deficiency including pernicious anemia. Other uses include treatment for cyanide poisoning, Leber's optic atrophy, and toxic amblyopia. It is given by injection into a muscle or vein.

Thallium poisoning is poisoning that is due to thallium and its compounds, which are often highly toxic. Contact with skin is dangerous and adequate ventilation should be provided when melting this metal. Many thallium compounds are highly soluble in water and are readily absorbed through the skin. Exposure to them should not exceed 0.1 mg per m2 of skin in an 8 hour time-weighted average.

Ethylene glycol poisoning is poisoning caused by drinking ethylene glycol. Early symptoms include intoxication, vomiting and abdominal pain. Later symptoms may include a decreased level of consciousness, headache, and seizures. Long term outcomes may include kidney failure and brain damage. Toxicity and death may occur after drinking even in a small amount as ethylene glycol is more toxic than other diols.

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Salicylate poisoning, also known as aspirin poisoning, is the acute or chronic poisoning with a salicylate such as aspirin. The classic symptoms are ringing in the ears, nausea, abdominal pain, and a fast breathing rate. Early on, these may be subtle, while larger doses may result in fever. Complications can include swelling of the brain or lungs, seizures, low blood sugar, or cardiac arrest.

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<span class="mw-page-title-main">Sodium thiosulfate (medical use)</span>

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References

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  10. Ruprecht J (1 July 2011). "Radioaktivität: Berliner Blau als Arzneimittel" [Radioactivity: Prussian Blue as a medicine]. Deutsches Ärzteblatt[German Medical Journal] (in German).
  11. Kubiak WD (27 June 2011). "Fukushima's Caesium Spew - Deadly Catch-22s in Japan Disaster Relief". Truthout. Archived from the original on 23 August 2019.
  12. "Questions and Answers on Calcium-DTPA and Zinc-DTPA (Updated)". U.S. Food & Drug Administration. 3 November 2018. Retrieved 21 March 2020.