Date: Fri, 11 Jun 2010 16:20:28 -0600
Reply-To: DCHAS-L Discussion List <DCHAS-L**At_Symbol_Here**LIST.UVM.EDU>
Sender: DCHAS-L Discussion List <DCHAS-L**At_Symbol_Here**LIST.UVM.EDU>
From: Alan Hall <ahalltoxic**At_Symbol_Here**MSN.COM>
Subject: Re: toxicity question
In-Reply-To: <F5D83326DC77FD4EA138E9194D6B28883371E83CA2**At_Symbol_Here**>

Nick et al,
I'm not sure that was what I'm saying.  I'm a Medical Toxicologist , not a medicinal or any other type of chemist.
What you have with any medication which may be in a salt form, the dose o f the active component in a given volume may be different based on the salt form.  The therapeutic dose may therefore differ, and the way in which the active component can be safely and efficaciously given may differ .
The solubility may or may not have anything do do with it.  Don't le t's get each other wrong.  You'd have to discuss the the diluent, and excipients, and a whole bunch of other issues for each compound.  ; This is not one in which a simple answer, chemistry or medicine, or toxicology would necessarily be correct in all cases.
Alan H. Hall, M.D.


Date: Fri, 11 Jun 2010 16:45:21 -0500
From: tsiakals**At_Symbol_Here**ILLINOIS.EDU
S ubject: Re: [DCHAS-L] toxicity question
To: DCHAS-L**At_Symbol_Here**LIST.UVM.EDU

Sounds like you=92re saying that co mparing the solubility of one salt to another plays a part in that overall dosing question.


That helps, Alan.  Thanks!




From: DCHAS-L Discussion List [mailto:DCHAS -L**At_Symbol_Here**LIST.UVM.EDU] On Behalf Of Alan Hall
Sent: Friday, Ju ne 11, 2010 9:41 AM
To: DCHAS-L**At_Symbol_Here**LIST.UVM.EDU
Subject: Re: [DCHAS-L] toxicity question


Nick et al,
In general, the toxici ty would not change with the salt involved, although there are exc eptions.  For example, when treating hydrofluoric acid (HF) exposu res with calcium salts, the calcium gluconate salt can be used topically , injected intradermally, or given intravenously or interarterially.&nb sp; However, the calcium chloride salt can only be injected intravenous ly, because it causes severe skin damage and sloughing if extravasated fr om a vein or injected intradermally and can cause devastating vascular inju ry if injected intraarterially.  
Calcium salt s are also a good example of the second point.  The dose of the acti ve ingredient can vary significantly with the same volume of different salt s.  In the calcium example, the calcium chloride salt in a given volume will have approximately 3 times more Ca+2 ion that the same vo lume of the calcium gluconate salt.  When treating life-threatening cardiovascular complications of hydrofluoric acid systemic toxicity, it i s therefore often wise to choose the calcium chloride salt for intravenous infusion (with precautions against extravaasation), as a much higher dose of calcium ion can provided with the same volume and the same infusion tim e.
A similar comparison might be made for norepinephrine, but what the relationship of dose is between various salt forms in the same volume, I don't have memorized.
Hope this answers the que stion.
Alan H. Hall, M.D.
President and  Chief Medical Toxicologist
Toxicology Consulting and Medical Translating Services, Inc.
Laramie, WY
Clinical Assistant Profes sor
Colorado School of Public Health
Denver, CO
> ; Date: Thu, 10 Jun 2010 16:30:45 -0500
> From: tsiakals**At_Symbol_Here**ILLINO IS.EDU
> Subject: [DCHAS-L] toxicity question
> To: DCHAS-L **At_Symbol_Here**LIST.UVM.EDU
> Good afternoon all,
> ; How does toxicity compare from one pharmaceutical salt to another? More specifically, is the toxicity of norepinephrine the same as norepinephri ne bitartrate salt?
> Thanks,
> -Nick

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