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HISTORICAL THERAPEUTIC USES OF ARSENIC


Arsenic is used as a healing agent after Greek physicians such as Hippocrates and Galen who popularized its use.

Compound arsenic solutions available as tablets, pastes, and in injectable forms.

Fowler's Solution

1% arsenic trioxide preparation, was widely used during the 19th century.

British Pharmaceutical and Therapeutic Products lists Fowler's solution as used for: leukaemia, skin conditions (psoriasis, dermatitis herpetiformis, and eczema), stomatitis and gingivitis in infants, and Vincent's angina.

Fowler's solution was also prescribed as a health tonic.

Chronic arsenic intoxication from long term use of Fowler's solution caused haemangiosarcoma, liver angiosarcoma and nasopharyngeal carcinoma.

Arsenic was the primary treatment for syphilis until World War II.

Arsphenamine (neoarsphenamine), a 30% arsenic light yellow compound was used intravenously to treat syphilis, yaws, and protozoan infections.

Paris Green

Copper(II) acetate triarsenite or copper(II) acetoarsenite.

A highly toxic inorganic emerald-green crystalline powder used as a rodenticide and insecticide, and also as a pigment, despite its toxicity.

It is also used as a blue colorant for fireworks.

The color of Paris Green is said to range from a pale blue green when very finely ground, to a deeper green when coarsely ground.

At the turn of the 20th century, Paris Green, blended with lead arsenate, is used in America and elsewhere as an insecticide on produce such as apples.

Paris Green is said "to have burned the trees and grass around the trees".


CURRENT THERAPEUTIC USES OF ARSENIC

Arsenic trioxide (As2O3) is now widely used to induce remission in patients with acute promyelocytic leukaemia, based on its mechanism as an inducer of apoptosis (programmed cell death).

Arsenic induces apoptosis by releasing an apoptosis-inducing factor (AIF) from the mitochondrial intermembrane space from where it translocates to the cell nucleus.

AIF then effects apoptosis, resulting in altered nuclear biochemistry, chromatin condensation, DNA fragmentation, and cell death.

AIF has been isolated and cloned and is a flavoprotein with a molecular weight of 57 000.


ACUTE ARSENIC POISONING

Diarrhea attributed to increased permeability of the blood vessels is a dominant feature.

Encephalopathy is a common manifestation and the possibility of arsenic toxicity must be considered if the aetiology of encephalopathy is uncertain.

The neurological effects are many and varied.

The most frequent finding is a peripheral neuropathy mimicking Guillain-Barré syndrome with similar electromyographic findings.

2015 Phosphate fertilizer source of arsenic in chronic kidney disease in Sri Lanka




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