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ACUTE EXPOSURE INFORMATION

  1. Little is known about the acute or chronic effects of methoxyethylmercuric acetate in humans. It can cause systemic effects through dermal exposure. Animal studies indicate that it can cause renal damage in a similar manner to inorganic mercury. Therefore this review is based on clinical effects of both organic and inorganic mercurials.
  1. Mercury compounds can be absorbed by all routes of exposure. The principal concerns from acute poisoning are sudden, profound circulatory collapse with tachycardia, hypotension and peripheral vasoconstriction, vomiting, and bloody diarrhea. Renal failure usually develops within 24 hours and may be life-threatening.
  1. Mercuric salts are corrosive and nephrotoxic. Salivation, metallic taste, abdominal pain, seizures, proteinuria, nephrotic syndrome (oliguria and anuria) may occur. Circulatory collapse, bloody diarrhea, and acute renal failure have been reported following peritoneal lavage with mercuric chloride.
  1. Toxicity from organic mercurials may be delayed up to weeks following exposure. Nausea, vomiting, abdominal pain, diarrhea, paresthesias of the lips and mouth and lethargy may occur. Various organomercurials are known human teratogens and can induce severe neurological defects in the unborn.
  1. The brain is the critical organ for chronic mercury poisoning. Tremor and psychological changes including increased irritability and sensitivity, xenophobia, insomnia, hallucinations, and mania may occur. Eventually there is spongeous degeneration of the brain with loss of many higher functions.
  1. When mercury poisoning is suspected in critically ill patients, chelation therapy should be started regardless of the form of mercury causing toxicity.
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