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This agent removes mercury Post Date: Wed, 15 Oct 2008 20:33:23 +0000 The capacity of mercurials to complex with thiols is so strong that only vanishingly low, trace amounts of free organic or inorganic mercury can exist within the body. However, mercurial diuresis can be prevented or terminated by the administration of dimercaprol. This agent removes mercury from the kidney; therefore, the renal receptor must have less affinity for mercuric ions than does dimercaprol, a dithiol. Autor of the post: Undefined Several observations appear to contradict Post Date: Wed, 15 Oct 2008 20:14:32 +0000 Monothiols neither prevent nor terminate diuresis, and some organic mercurials, such as mercaptomerin, are administered complexed with a monothiol and are active in this form. This suggests that the renal receptor has a greater affinity for the mercurial than does a monothiol. Several observations appear to contradict the mercuric ion hypothesis, the most important of which is the find-ing of inorganic mercury produced in vivo after the administration of a nondiuretic organic mercurial compound. Autor of the post: Undefined In therapeutic doses, the important Post Date: Wed, 15 Oct 2008 19:58:41 +0000 The current status of the problem has been evaluated critically by Cafruny and associates (1973) and Clarkson and Vostal (1973).Effect on Renal Tubular Transport. In therapeutic doses, the important actions of mercurials are limited to the inhibition of the tubular reabsorption of so-dium and chloride and to the excretion of potassium. Autor of the post: Undefined During diuresis, the urine contains Post Date: Wed, 15 Oct 2008 19:46:54 +0000 Inhibition of organic acid secretion is seen in man but not in the dog. In the chimpanzee and to a lesser extent in man, certain mercurials have an intense uricosuric action (Fanelli et al, 1973).During diuresis, the urine contains a high concen-tration of chloride anion matched by almost equiva-lent amounts of sodium. Autor of the post: Undefined In metabolic alkalosis induced Post Date: Wed, 15 Oct 2008 19:33:40 +0000 (See Table 39-1, page 826.) There is also a partial correlation between the plasma chloride concentration and the diuretic re-sponse. In metabolic alkalosis induced by sodium bicarbonate, the plasma chloride is low and mer-curials are ineffective; in metabolic acidosis induced by ammonium chloride, the plasma chloride is ele-vated and mercurials are potentiated. Autor of the post: Undefined The effects of the mercurial diuretics Post Date: Wed, 15 Oct 2008 19:23:30 +0000 However, there are less common conditions in which the correlation fails to hold—the chronic administration of ammo-nium chloride, the administration of ammonium nitrate, and during hypokalemic alkalosis with para-doxical aciduria. In these situations, mercurials are effective even in the presence of hypochloremia.The effects of the mercurial diuretics on potassium excretion are complex. Autor of the post: Undefined However, mercurials have a paradoxical Post Date: Wed, 15 Oct 2008 19:07:18 +0000 The mercurials depress the tubular secretion of potassium. For this reason, diuresis produced by mercurials is accompanied by significantly less potassium loss than occurs with other diuretics that do not inhibit the secretory mechanism. However, mercurials have a paradoxical action in increasing slightly the excretion of potas-sium when initial excretory rates are low. Autor of the post: Undefined Results obtained with differentinvestigative technics Post Date: Wed, 15 Oct 2008 18:50:24 +0000 The site of mercurial action has been examined extensively. There can be little doubt that inhibition of para-aminohippuric acid (PAH) secretion is prox-imal and inhibition of potassium secretion is distal However, as far as the reabsorption of sodium and chloride is concerned, the site of mercurial action is less well established and, indeed, may involve multi-ple segments of the nephron, each possibly to a variable degree depending upon the precise experi-mental conditions. Results obtained with differentinvestigative technics have been summarized by Suki and coworkers (1973). Autor of the post: Undefined In attempting to define Post Date: Wed, 15 Oct 2008 18:35:56 +0000 From micropuncture studies in the dog, the major site of action has been assigned to the ascending limb (Evanson et al, 1972). At this same site a primary inhibition of chloride transport has been identified (Burg and Green, 1973b). In attempting to define a cellular or biochemical site of action, studies with mercurials have been compli-cated by the capacity of these agents to react with multiple cell components. Autor of the post: Undefined Asa result Post Date: Wed, 15 Oct 2008 18:18:01 +0000 Many of the findings ap-pear quantitatively inconsistent, and it is not yet possible to define the mechanisms of mercurial ac-tion at the molecular level (see Nechay, 1973; Suki et al, 1973).Effect on Composition of Extracellular Fluid. Asa result of the loss of fluid containing sodium and chloride in approximately equal amounts and virtu-ally devoid of bicarbonate, a mercurial diuresis tends to produce a metabolic alkalosis. 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