The
element mercury exists as inorganic, elemental, or organic species. Routes of exposure and toxicity in humans vary according to the species of
mercury involved. Treatment of
mercury poisoning generally requires the use of sulfhydryl bond-containing chelation agents, including the parenterally administered
dimercaprol and its oral congeners. These oral
chelators, meso-2,3-dimercaptosuccinic
acid and
sodium 2,3-dimercapto-1-propanesulfonate, have numerous advantages over
dimercaprol, including less toxicity. Although
dimercaprol is contraindicated in organic
mercury exposures, meso-2,3-dimercaptosuccinic
acid and
sodium 2,3-dimercapto-1-propanesulfonate may be used to chelate all species of
mercury. Recent evidence suggests that their efficacy in
organic mercury poisoning is uncertain.