Barium toxicity and the role of the potassium inward rectifier current

Bhoelan, B. Soerajja; Stevering, C. H.; Boog, Arthur T.J. van der; Heyden, Marcel A.G. van der

doi:10.3109/15563650.2014.923903

Cited by 77 publications

(42 citation statements)

References 76 publications

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“…Finally, hypokalaemia occurred, most likely resulting from an extra‐intracellular potassium shift. This findings strongly reflects the course seen in barium poisoning cases in man (Bhoelan et al, ). Interestingly, potassium administration to dogs counteracted most of the clinical signs (Roza and Berman, ).…”

Section: Discussionsupporting

confidence: 83%

The inward rectifier current inhibitor PA‐6 terminates atrial fibrillation and does not cause ventricular arrhythmias in goat and dog models

Yuan

Varkevisser

Opačić

et al. 2017

British J Pharmacology

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Background and PurposeThe density of the inward rectifier current (IK1) increases in atrial fibrillation (AF), shortening effective refractory period and thus promoting atrial re‐entry. The synthetic compound pentamidine analogue 6 (PA‐6) is a selective and potent IK1 inhibitor. We tested PA‐6 for anti‐AF efficacy and potential proarrhythmia, using established models in large animals.Experimental ApproachPA‐6 was applied i.v. in anaesthetized goats with rapid pacing‐induced AF and anaesthetized dogs with chronic atrio‐ventricular (AV) block. Electrophysiological and pharmacological parameters were determined.Key ResultsPA‐6 (2.5 mg·kg−1·10 min−1) induced cardioversion to sinus rhythm (SR) in 5/6 goats and prolonged AF cycle length. AF complexity decreased significantly before cardioversion. PA‐6 accumulated in cardiac tissue with ratios between skeletal muscle : atrial muscle : ventricular muscle of approximately 1:8:21. In SR dogs, PA‐6 peak plasma levels 10 min post infusion were 5.5 ± 0.9 μM, PA‐6 did not induce significant prolongation of QTc and did not affect heart rate, PQ or QRS duration. In dogs with chronic AV block, PA‐6 did not affect QRS but lengthened QTc during the experiment, but not chronically. PA‐6 did not induce TdP arrhythmias in nine animals (0/9) in contrast to dofetilide (5/9). PA‐6 (200 nM) inhibited IK1, but not IK,ACh, in human isolated atrial cardiomyocytes.Conclusion and ImplicationsPA‐6 restored SR in goats with persistent AF and, in dogs with chronic AV block, prolonged QT intervals, without inducing TdP arrhythmias. Our results demonstrate cardiac safety and good anti‐AF properties for PA‐6.

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Section: Discussionsupporting

confidence: 83%

The inward rectifier current inhibitor PA‐6 terminates atrial fibrillation and does not cause ventricular arrhythmias in goat and dog models

Yuan

Varkevisser

Opačić

et al. 2017

British J Pharmacology

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“…It has a high chemical reactivity and is never found in nature as a free element. It is highly toxic upon acute and chronic exposures (Bhoelan et al, 2014). Barium has been tested for its toxicity in different studies (Llugany et al, 2000;Langdon, 1994;Akinfieva and Gerasimova, 1984).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Barium Carbonate Toxicity on the Developmental Stages of Sarcophaga ruficornis (Diptera: Sarcophagidae)

Singh¹,

Singh²,

Kaur³

et al. 2017

Int.J.Curr.Microbiol.App.Sci

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“…It has been reported that the mechanism of barium ion poisoning resulting in hypokalemia is associated with the ability of the sodium potassium pump (Na + -K + -ATP enzyme) [5]. The Na + -K + -ATP enzyme is involved in transmembrane transport of potassium against concentration in intake within the cell.…”

Section: Discussionmentioning

confidence: 99%

Inconceivable Hypokalemia: A Case Report of Acute Severe Barium Chloride Poisoning

Tao

Man

Shi

et al. 2016

Case Reports in Medicine

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Barium is a heavy divalent alkaline earth metal that has been known as a muscle poison. Barium can cause human toxicity, which may lead to significant hypokalemia and have serious consequences. This paper reports a case of unprecedented barium intoxication in which the patient, who suffered from depression, swallowed at least 3.0 g barium chloride to commit suicide. On admission, the patient presented with nausea, vomiting, stomach burning feeling, dizziness, and weakness. Emergency biochemical testing showed that the patient was suffering from severe hypokalemia (K+ 1.7 mmol/L). His electrocardiogram (ECG) prompted atrioventricular blocking, ventricular tachycardia, prolongation of PR interval, ST segment depression with U waves, and T wave inversion. Intravenous potassium supplements were given immediately to correct hypokalemia and regular monitoring of vital signs and fluid balance was arranged. After all-out rescue of our hospital personnel, the condition of the patient is currently stable and he is gradually recovering. This case exemplifies the weaknesses of the management of toxic substances and the lack of mental health education for young people. We hope to get more attention for the supervision of toxic substances and the healthy development of young people.

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Barium toxicity and the role of the potassium inward rectifier current

Cited by 77 publications

References 76 publications

The inward rectifier current inhibitor PA‐6 terminates atrial fibrillation and does not cause ventricular arrhythmias in goat and dog models

The inward rectifier current inhibitor PA‐6 terminates atrial fibrillation and does not cause ventricular arrhythmias in goat and dog models

Assessment of Barium Carbonate Toxicity on the Developmental Stages of Sarcophaga ruficornis (Diptera: Sarcophagidae)

Inconceivable Hypokalemia: A Case Report of Acute Severe Barium Chloride Poisoning

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