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Previous by Date: Subject: Re: toxicity question Date: Fri, 11 Jun 2010 16:20:28 -0600 Author: Alan Hall |
Next by Date: Subject: Re: toxicity question Date: Fri, 11 Jun 2010 16:59:14 -0600 Author: Alan Hall |
Nick,
Just to elucidate the issue, erythromycin ethly succinate (EES)&nb
sp;in certain forms could cause non-obstructive colestaitc jaundice in ce
rtain clinical scenarios, while all other forms of erythromycin did not d
o so. Outdated tetracycline in some salt forms could injure the kid
neys, while non-outdated forms of the same antibiotic did not.
I regret that from the toxicological standpoint, your question cannot be
simply answered. In a long life as a medical toxicologist, I find
that there really are not often any simple answers. The more we le
arn, sometimes the less certain we become.
Alan
ahalltoxic**At_Symbol_Here**msn.com
Sounds like you=92re saying that co mparing the solubility of one salt to another plays a part in that overall dosing question.
That helps, Alan. Thanks!
-Nick
From: DCHAS-L Discussion List [mailto:DCHAS
-L**At_Symbol_Here**LIST.UVM.EDU] On Behalf Of Alan Hall
Sent: Friday, Ju
ne 11, 2010 9:41 AM
To: DCHAS-L**At_Symbol_Here**LIST.UVM.EDU
Subject:
Re: [DCHAS-L] toxicity question
Nick et al,
In general, the toxici
ty would not change with the salt involved, although there are exc
eptions. For example, when treating hydrofluoric acid (HF) exposu
res with calcium salts, the calcium gluconate salt can be used topically
, injected intradermally, or given intravenously or interarterially.&nb
sp; However, the calcium chloride salt can only be injected intravenous
ly, because it causes severe skin damage and sloughing if extravasated fr
om a vein or injected intradermally and can cause devastating vascular inju
ry if injected intraarterially.
Calcium salt
s are also a good example of the second point. The dose of the acti
ve ingredient can vary significantly with the same volume of different salt
s. In the calcium example, the calcium chloride salt in a
given volume will have approximately 3 times more Ca+2 ion that the same vo
lume of the calcium gluconate salt. When treating life-threatening
cardiovascular complications of hydrofluoric acid systemic toxicity, it i
s therefore often wise to choose the calcium chloride salt for intravenous
infusion (with precautions against extravaasation), as a much higher dose
of calcium ion can provided with the same volume and the same infusion tim
e.
A similar comparison might be made for norepinephrine,
but what the relationship of dose is between various salt forms in the same
volume, I don't have memorized.
Hope this answers the que
stion.
Alan
Alan H. Hall, M.D.
President and
Chief Medical Toxicologist
Toxicology Consulting and Medical Translating
Services, Inc.
Laramie, WY
Clinical Assistant Profes
sor
Colorado School of Public Health
Denver, CO
>
; Date: Thu, 10 Jun 2010 16:30:45 -0500
> From: tsiakals**At_Symbol_Here**ILLINO
IS.EDU
> Subject: [DCHAS-L] toxicity question
> To: DCHAS-L
**At_Symbol_Here**LIST.UVM.EDU
>
> Good afternoon all,
>
>
; How does toxicity compare from one pharmaceutical salt to another? More
specifically, is the toxicity of norepinephrine the same as norepinephri
ne bitartrate salt?
>
> Thanks,
> -Nick
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