A) USES: Soluble barium salts are used in some rodenticides, in welding fluxes and some depilatories, in glass manufacture, in textile dyeing, in explosive detonators and fireworks (sparklers).
B) TOXICOLOGY: Rapid onset, severe hypokalemia is caused by sequestration of potassium in skeletal muscle cells, secondary to barium blocking potassium efflux via the sodium-potassium pump in those cells.
C) EPIDEMIOLOGY: Poisoning is rare, and most often occurs when barium carbonate, a white powder, is mistaken for flour, or after deliberate ingestion. Toxicity from dermal exposure to intact skin or inhalation has not been reported. One case describes systemic toxicity after an explosion, with presumed barium absorption through wounds and burns.
D) WITH POISONING/EXPOSURE
1) MILD TO MODERATE POISONING: Nausea, vomiting, colicky abdominal pain and diarrhea, paresthesias, increased salivation, onset usually within one hour. Chronic inhalation can produce a pneumoconiosis (baritosis). Barium oxide and barium hydroxides are alkaline in contact with water, can cause burns.
2) SEVERE POISONING: Profound hypokalemia, tremors, seizures, vertigo, severe muscle weakness, mydriasis, hypertension, chest pain, bradycardia, ventricular dysrhythmias, respiratory failure, shock, and cardiac arrest.
0.2.3 VITAL SIGNS
0.2.3.1 ACUTE EXPOSURE
A) WITH POISONING/EXPOSURE
1) Hypertension may occur.
0.2.20 REPRODUCTIVE HAZARDS
A) At the time of this review, no reproductive studies were found for barium in humans.
0.2.21 CARCINOGENICITY
0.2.21.1 IARC CATEGORY
A) IARC Carcinogenicity Ratings for CAS7440-39-3 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
1) Not Listed
0.2.21.3 ANIMAL OVERVIEW
A) Limited studies of oral exposure have been negative. Intratracheal barium sulfate is reported to cause bronchogenic carcinoma in rats.
0.2.22 GENOTOXICITY
A) Limited genotoxicity tests with barium salts have been largely negative.
The information contained in the Truven Health Analytics Inc. products is intended as an educational aid only. All treatments or procedures are intended to serve as an information resource for physicians or other competent healthcare professionals performing the consultation or evaluation of patients and must be interpreted in view of all attendant circumstances, indications and contraindications. The use of the Truven Health Analytics Inc. products is at your sole risk. These products are provided "as is" and "as available" for use, without warranties of any kind, either express or implied. Truven Health Analytics Inc. makes no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the productsAdditionally, Truven Health ANALYTICS INC. makes no representation or warranties as to the opinions or other service or data you may access, download or use as a result of use of the Truven Health ANALYTICS INC. products. All implied warranties of merchantability and fitness for a particular purpose or use are hereby excluded. Truven Health Analytics Inc. does not assume any responsibility or risk for your use of the Truven Health Analytics Inc. products.
0.2.1 SUMMARY OF EXPOSURE
0.2.1.1 ACUTE EXPOSURE
A) USES: Potassium permanganate is an antiseptic and astringent agent with powerful oxidizing effects. Industrial uses include bleaching resins, waxes, fats, oils, straw, cotton, silk and other fibers and chamois skins. It is also used as a disinfectant, deodorant, sanitizer, chemical in photography, and reagent in analytical and synthetic organic chemistry. Illicit uses have included the production of drugs of abuse and induction of abortion by topical application to the vaginal wall. Historically, potassium permanganate has been used as a urethral irrigant, and lavage fluid for alkaloid poisoning.
B) TOXICOLOGY: Potassium permanganate reacts with water to yield manganese dioxide, potassium hydroxide, and oxygen. Potassium hydroxide is a strong alkaline corrosive. In severe cases, systemic effects including disseminated intravascular coagulation (DIC), methemoglobinemia, hepatitis, pancreatitis, and acute renal failure may occur and are possibly caused by free radical generation. Chronic ingestion may cause neurotoxicity, including paresthesias, tremor, and Parkinsonism due to manganese toxicity. Neurotoxicity from manganese results from dopamine depletion and production of the neurotoxins, dopamine quinone and hydrogen peroxide.
C) EPIDEMIOLOGY: Patients may be exposed to potassium permanganate by occupational contact or illicit uses.
D) WITH POISONING/EXPOSURE
1) MILD TO MODERATE TOXICITY: Skin contact with concentrated solutions may cause severe irritation and burns. Contact with diluted solutions can cause purple brown staining of the skin and hardening of the outer layer of the skin. Potassium permanganate may be irritating to the respiratory tract, causing upper airway edema, chest tightness, and coughing. Caustic injury to the mouth and gastrointestinal tract may also occur after ingestion. Eye exposure can cause conjunctival discoloration and corneal and conjunctival burns.
2) SEVERE TOXICITY: Severe gastrointestinal burns have been reported after ingestion. Patients may also develop adult respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), methemoglobinemia, tachycardia, hypotension, metabolic acidosis, coagulopathy, hepatic necrosis, pancreatitis, and acute renal failure. Strictures and gastric outlet obstruction may develop as delayed complications following gastrointestinal burns. Chronic ingestion may cause neurotoxicity, paresthesias, tremor, and Parkinsonism due to manganese toxicity. Potassium permanganate use as an abortifacient may result in vaginal or cervical burns and erosions, with extensive bleeding, shock, severe scarring and miscarriage as possible complications.
0.2.3 VITAL SIGNS0.2.21 CARCINOGENICITY
0.2.21.1 IARC CATEGORY
A) IARC Carcinogenicity Ratings for CAS7722-64-7 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
1) Not Listed
0.2.21.2 HUMAN OVERVIEW
A) At the time of this review, no studies were found on the possible carcinogenic activity of potassium permanganate in humans or experimental animals.
The information contained in the Truven Health Analytics Inc. products is intended as an educational aid only. All treatments or procedures are intended to serve as an information resource for physicians or other competent healthcare professionals performing the consultation or evaluation of patients and must be interpreted in view of all attendant circumstances, indications and contraindications. The use of the Truven Health Analytics Inc. products is at your sole risk. These products are provided "as is" and "as available" for use, without warranties of any kind, either express or implied. Truven Health Analytics Inc. makes no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the productsAdditionally, Truven Health ANALYTICS INC. makes no representation or warranties as to the opinions or other service or data you may access, download or use as a result of use of the Truven Health ANALYTICS INC. products. All implied warranties of merchantability and fitness for a particular purpose or use are hereby excluded. Truven Health Analytics Inc. does not assume any responsibility or risk for your use of the Truven Health Analytics Inc. products.
