Aluminum, Elemental

CAS RN:7429-90-5

Treatment Overview

0.4.2 ORAL EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE EXPOSURE
    • 1) Significant toxicity is unlikely, treatment is symptomatic and supportive.
  • B) MANAGEMENT OF SEVERE EXPOSURE
    • 1) Reduce exposure through decreased use of aluminum containing phosphate buffers. Dialysis patients with encephalopathy, osteomalacia or anemia should be chelated with deferoxamine.
  • C) DECONTAMINATION
    • 1) Insoluble forms of aluminum are poorly absorbed from the gastrointestinal tract, decontamination is generally not necessary. Soluble forms of aluminum (eg aluminum fluoride, chloride or sulfate) may be irritating or corrosive; dilution with milk or water may be of benefit. Wash exposed skin with soap and water. Irrigate exposed eyes.
  • D) ENHANCED ELIMINATION
    • 1) Hemodialysis alone will remove little aluminum because of its binding to transferrin. Deferoxamine combined with hemodialysis should be used in renal failure patients with encephalopathy, anemia or osteomalacia related to aluminum. One regimen is 5 mg/kg given 5 hours before the start of a hemodialysis session. Weeks to months of therapy is usually required.
  • E) PATIENT DISPOSITION
    • 1) HOME CRITERIA: Patients with inadvertent acute ingestion can be managed at home. Patients with significant GI, pulmonary, or eye irritation should be referred to a healthcare facility.
    • 2) OBSERVATION CRITERIA: Patients with deliberate ingestions, and those with significant GI, respiratory or eye irritation should be evaluated and observed until symptoms improve.
    • 3) ADMISSION CRITERIA: Renal failure patients with aluminum encephalopathy should be admitted.
    • 4) CONSULT CRITERIA: Consult a medical toxicologist or poison center for patients with significant symptoms or in whom the diagnosis is unclear. Consult a nephrologist for renal failure patients with suspected aluminum intoxication.
  • F) PHARMACOKINETICS
    • 1) Insoluble aluminum salts are poorly absorbed (estimated 1% to 2%). Unabsorbed aluminum is eliminated in feces, absorbed aluminum is eliminated renally. Aluminum is widely distributed, most is bound in bone or high molecular weight complexes. About 85% to 90% of intravenously administered aluminum is eliminated within an hour, but the terminal elimination half life increases with time (up to years). In renal failure patients who stop taking aluminum containing medications, half-lives were in the range of 13 to 85 days.
  • G) PITFALLS
    • 1) The biggest risk of acute exposure is overtreatment. In dialysis patients with suspected aluminum encephalopathy, careful evaluation for other potential etiologies is important.
  • H) DIFFERENTIAL DIAGNOSIS
    • 1) Other causes of encephalopathy (eg infectious, metabolic, intracranial bleeding or mass).
0.4.4 EYE EXPOSURE
  • A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.
0.4.5 DERMAL EXPOSURE
  • A) OVERVIEW
    • 1) Most cases of aluminum-related dermal reactions are due to chronic exposure.
Find more information on this substance at: Hazardous Substances Data Bank , TOXNET , PubMed