Therapeutic Review: Do Diethyldithiocarbamate and Disulfiram Have a Role in Acute Nickel Carbonyl Poisoning?

Abstract

Animal studies demonstrate that diethyldithiocarbamate is an effective antidote in acute nickel carbonyl poisoning when it is administered parenterally soon after exposure. However, as no adequately controlled clinical studies have been performed, further clinical data are required before diethyldithiocarbamate can be recommended routinely in acute nickel carbonyl poisoning. If diethyldithiocarbamate is to be employed, it should be administered parenterally soon after exposure as delay in administration may increase nickel carbonyl toxicity. There are currently insufficient data to recommend disulfiram as an alternative to diethyldithiocarbamate even when diethyldithiocarbamate is not available.

Chelators as Antidotes of Metal Toxicity: Therapeutic and Experimental Aspects

“…Disulfiram, another nickel-chelating agent, was used in nickel dermatitis [56][57][58] and in the case of nickel carbonyl poisoning [59]. However, due to its hepatotoxicity and possible redistribution of nickel to the brain, its use in both indications is still controversial [58,60]. Hexavalent chromium compounds can exert serious toxic effects.…”

Trioxane Ingestion in a Child

“…However, these treatments are not benign, and human experience is not well described. 19 Our patient was given folic acid to enhance conversion of formate to carbon dioxide and water, as has been shown to be effective in animal models, but this is not approved by the Food and Drug Administration. 20 Our patient was transferred to a facility capable of pediatric hemodialysis when his bicarbonate decreased.…”

Antimony and Nickel

“…Given at a dose of 1000 mg/kg to rats, disulfiram offered complete protection against nickel carbonyl-induced toxicity when administered after exposure; however, 500 mg/kg offered no protection [122]. Doses greater than 1500 mg/kg seemed to enhance mortality.…”