Prussian blue (medical use)

Prussian blue

Prussian blue
Clinical data
Trade names Radiogardase, others
AHFS/Drugs.com Monograph
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration
by mouth
ATC code
Identifiers
CAS Number
PubChem CID
ChemSpider
UNII
Chemical and physical data
Molar mass 859.24

Prussian blue, also known as potassium ferric hexacyanoferrate, is used as a medication to treat thallium poisoning or radioactive cesium poisoning.[1][2] For thallium it may be used in addition to gastric lavage, activated charcoal, forced diuresis, and hemodialysis.[3][4] It is given by mouth or nasogastric tube.[2][4] Prussian blue is also used in the urine to test for G6PD deficiency.[5]

Side effects may include constipation, low blood potassium, and stools that are dark.[1][3] With long term use, sweat may turn blue.[3] It works by binding to and thus preventing the absorption of thallium and cesium from the intestines.[3]

Prussian blue was developed around 1706.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] As of 2016 it is only approved for medical use in Germany and the United States.[8][9] In the United States a course of treatment costs more than 200 USD.[2] Access can be difficult in many areas of the world including the developed world.[10]

Medical uses

Prussian blue is used to treat thallium poisoning or radioactive cesium poisoning.[1][2] It may also be used for exposure to radioactive material until the underlying type is determined.[3]

Often it is given with mannitol or sorbital to increase the speed it moves through the intestines.[4]

Prussian Blue is also used to detect hemosiderin in urine to confirm a diagnosis of G6PD deficiency.[5]

Thallium poisoning

For thallium it may be used in addition to gastric lavage, forced diuresis, and hemodialysis.[3]

It is given until the amount of thallium in the urine drops to below 0.5 mg per day.[4]

Cesium poisoning

It is specifically only used for radioactive cesium poisoning when the cesium has entered the body either by swallowing or breathing it in.[4]

References

  1. 1 2 3 WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 65. ISBN 9789241547659. Retrieved 8 January 2017.
  2. 1 2 3 4 Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 472. ISBN 9781284057560.
  3. 1 2 3 4 5 6 "Prussian Blue". The American Society of Health-System Pharmacists. Retrieved 8 January 2017.
  4. 1 2 3 4 5 Dart, Richard C. (2004). Medical Toxicology. Lippincott Williams & Wilkins. p. 248,279. ISBN 9780781728454.
  5. 1 2 "Glucose-6-phosphate dehyrogenase deficiency — Medlibes: Online Medical Library". medlibes.com. Retrieved 2017-05-03.
  6. Hall, Alan H.; Isom, Gary E.; Rockwood, Gary A. (2015). Toxicology of Cyanides and Cyanogens: Experimental, Applied and Clinical Aspects. John Wiley & Sons. p. 43. ISBN 9781118628942.
  7. "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Retrieved 8 December 2016.
  8. Goyer, Robert A. (2016). Metal Toxicology: Approaches and Methods. Elsevier. p. 93. ISBN 9781483288567.
  9. Dobbs, Michael R. (2009). Clinical Neurotoxicology: Syndromes, Substances, Environments. Elsevier Health Sciences. p. 280. ISBN 0323052606.
  10. Archiver, Truthout (27 June 2011). "Fukushima's Cesium Spew - Deadly Catch-22s in Japan Disaster Relief". Truthout. Retrieved 15 January 2017.
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