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Drug Metabolism and Personalized Therapy

Official journal of the European Society of Pharmacogenomics and Personalised Therapy

Editor-in-Chief: Llerena, Adrián

Editorial Board: Benjeddou, Mongi / Chen, Bing / Dahl, Marja-Liisa / Devinsky, Ferdinand / Hirata, Rosario / Hubacek, Jaroslav A. / Ingelman-Sundberg, Magnus / Maitland-van der Zee, Anke-Hilse / Manolopoulos, Vangelis G. / Marc, Janja / Melichar, Bohuslav / Meyer, Urs A. / Nair, Sujit / Nofziger, Charity / Peiro, Ana / Sadee, Wolfgang / Salazar, Luis A. / Simmaco, Maurizio / Turpeinen, Miia / Schaik, Ron / Shin, Jae-Gook / Visvikis-Siest, Sophie / Zanger, Ulrich M.


CiteScore 2018: 1.01

SCImago Journal Rank (SJR) 2018: 0.277
Source Normalized Impact per Paper (SNIP) 2018: 0.446

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2363-8915
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Volume 34, Issue 2

Issues

Treatment of adult lead poisoning with D-penicillamine

Maryam Paeezi
  • Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nasim Zamani
  • Corresponding author
  • Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran
  • Department of Clinical Toxicology, Loghman Hakim Hospital, South Karegar Street, Tehran, Iran, Phone/Fax: 00982155424041
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hossein Hassanian-Moghaddam
  • Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Shahin Shadnia
  • Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Naghmeh Zamani
  • Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Vahid Chaleshi
  • Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Amir Ali Mafi
Published Online: 2019-06-06 | DOI: https://doi.org/10.1515/dmpt-2019-0003

Abstract

Background

The aim of the current study was to evaluate the efficacy of D-penicillamine in the treatment of lead poisoning mainly in the outpatient setting.

Methods

In a case series study performed during the recent epidemic of lead poisoning in Iran, lead-poisoned patients referring to our outpatient clinic were treated with 250-mg D-penicillamine capsules administered every 6 h for 5 or 10 days based on availability of the medication. They were recommended to re-check blood lead level (BLL) 4 weeks after cessation of the treatment and refer to our clinic again.

Results

In 63 patients with lead poisoning but without signs and symptoms of lead encephalopathy, median BLL was 106 [84, 131] μg/dL on presentation, which declined to a mean of 52.6 ± 28.8 μg/dL after a median treatment period of 7 [5, 10] days (p < 0.001). There was no statistically significant difference between the 5- and 10-day treatment protocols regarding complications and recovery. Treatment had resulted in a median decrease of 54 μg/dL [33, 90] (range: −20 to 231 μg/dL) in the patients’ BLLs (33.9% declined in BLL measurements; range: −29.69% to 99.06%).

Conclusions

D-penicillamine may be an acceptable substitute treatment in adult lead poisoning. Although our sample size was limited, we could not detect any serious adverse effects in our cases showing that D-penicillamine resulted in acceptable recovery rates. This may be helpful especially in epidemics with limitations in antidote access.

Keywords: D-penicillamine; lead; opium; poisoning; treatment

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About the article

Received: 2019-01-29

Accepted: 2019-04-12

Published Online: 2019-06-06


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Drug Metabolism and Personalized Therapy, Volume 34, Issue 2, 20190003, ISSN (Online) 2363-8915, DOI: https://doi.org/10.1515/dmpt-2019-0003.

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