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©2013 UpToDate ® Print Email Adverse effects of chelating agents used for arsenic poisoning Chelating agent Adverse effects BAL Endpoint: 24-hour urinary arsenic <50 µg/L or until another agent is substituted Hypertension Febrile reaction, diaphoresis Nausea, vomiting, salivation Lacrimation, rhinorrhea Headache Painful injection, injection site sterile abscess Hemolysis in G6PD-deficient patients Chelation of essential metals (prolonged course) Succimer Endpoint: 24-hour urinary arsenic <50 µg/L Nausea, vomiting, diarrhea Abdominal gas, pain Transient elevations in hepatic amino transferases, and alkaline phosphatase Rash, pruritus Sore throat, rhinorrhea Drowsiness, paresthesias Thrombocytosis, eosinophilia DMPS Endpoint: 24 hour urinary arsenic<50 µg/L Allergic reactions Increased copper and zinc excretion Nausea Pruritus Vertigo Weakness Adapted with permission from: Ford MD. Arsenic. In: Goldfrank's Toxicological Emergencies, Goldfrank L, Flomenbaum N, Howland MA, Hoffman R, Nelson L (Eds), Mcgraw-Hill, New York 2002. p.1183. Copyright © 2002 McGraw Hill.