- TIME COURSE: Adverse health effects due to poisoning with arsenic pentoxide occur over a range of time.
- Immediate: garlic or metallic taste, burning feeling of the affected mucous membranes, and cough.
- Within minutes of exposure: thirst, nausea, and vomiting.
- Within minutes to hours: decreased circulating blood volume (hypovolemia), low blood pressure (hypotension), diarrhea, abdominal pain, blood in the urine (hematuria), shortness of breath, chest pain, fluid accumulation in the lungs (pulmonary edema), degenerative disease or dysfunction of the brain (encephalopathy), and seizures.
- Over hours: bloody stools (hematochezia and melena), rice water like stools, and worsening of central nervous system function including confusion and delirium.
- Over hours to days: protein and blood in the urine, kidney failure.
- Over days: fatty degeneration of the liver; central liver necrosis, with yellowing of the skin (jaundice) due to liver damage.
- Over several weeks: decrease in numbers of specific blood cell types, sensory and motor neuropathy, and skin changes.
- EFFECTS OF SHORT-TERM (LESS THAN 8-HOURS) EXPOSURE: Within minutes to hours following arsenic pentoxide ingestion the patient/victim may experience nausea, vomiting, abdominal pain, and “rice water” like diarrhea.
Patient/victims suffering from less severe arsenic pentoxide toxicity may experience the following adverse health effects:- Gastrointestinal: Metallic taste or irritation of the top of the mouth and back of the throat (oropharynx) and inflammation of the pharynx (pharyngitis). Persistent inflammation of the stomach lining (gastroenteritis) with possible ulcerative lesions and bleeding (hemorrhage).
- Dermal: toxic inflammation and redness of the skin (erythroderma) with skin shedding (exfoliative dermatitis) may result from a hypersensitivity reaction to arsenic pentoxide.
- Mild low blood pressure (hypotension).
In addition to the above, patient/victims suffering from severe arsenic pentoxide intoxication may experience the following multisystem adverse health effects:- Cardiovascular: heart rate disturbances (sinus tachycardia and ventricular dysrhythmias), low blood pressure caused by change in position (orthostatic hypotension), shock, heart (myocardial) dysfunction, false heart attack (mimicked myocardial infarction), and loss of circulating blood volume (hypovolemia) from leaking capillaries.
- Central nervous system: acute degenerative disease or dysfunction of the brain (encephalopathy) may develop and progress over several days, delirium, and confusion. Seizures may be caused by brain swelling (cerebral edema) and brain vessel bleeding (microhemorrhages). Seizures and fainting (syncope) may be caused by heart rate irregularities as opposed to being primarily neurological.
- Respiratory system: accumulation of fluid in the lungs (pulmonary edema), acute respiratory distress syndrome (ARDS), and respiratory failure.
- Liver (hepatic): inflammation of the liver (hepatitis).
- Kidney (renal): acute kidney (renal) failure due to low blood pressure (hypotension), deposition of muscle or blood proteins in the kidneys (tubular deposition of myoglobin or hemoglobin), or direct kidney toxicity.
- Fever.
- Unusual complications: injury to the nerve supply of the diaphragm and larynx (phrenic nerve paralysis), paralysis of muscles on one side of the face (unilateral facial nerve palsy), inflammation of the pancreas (pancreatitis), and inflammation of the lining surrounding the heart and lungs (pericarditis and pleuritis).
- EYE EXPOSURE:
- Arsenic pentoxide dust causes eye irritation, itching, burning, mild temporary redness and/or inflammation of the eye membrane (conjunctivitis), watering (lacrimation), temporary double vision (diplopia), abnormal sensitivity to light (photophobia), vision dimness, and other transient eye damage or lesion formation (ulceration).
- INGESTION EXPOSURE:
- The classic presentation of arsenic pentoxide toxicity revolves around the gastrointestinal symptoms described in Signs/Symptoms, General. Other signs and symptoms include fluid in the lungs (pulmonary edema), adult respiratory distress (ARS), toxic delirium, pain in the extremities and muscles, absence of urination (anuria), blood and protein in the urine (hematuria and proteinuria), tissue swelling in the extremities (peripheral edema), headache, loss of appetite (anorexia), and vertigo. Skin findings are uncommon but may include flushing and sweating (diaphoresis). Severe toxicity may cause respiratory failure, kidney damage and failure, cellular liver damage (hepatocellular damage), and mania.
- See also Inhalation.
- INHALATION EXPOSURE:
- Inhalation of arsenic pentoxide may cause respiratory tract irritation, cough, sore throat, shortness of breath, chest pain, fluid in the lungs (pulmonary edema, headache, dizziness, and weakness).
- See also Ingestion.
- SKIN EXPOSURE:
- Skin contact with arsenic pentoxide may cause redness from capillary dilation (erythema), burning sensation, pain, itchy rash, swelling, and eruptions. These effects may be increased in the presence of humid environments, moisture, or perspiration on the skin.
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