From Big Medical Encyclopedia

ANTIMONY (Stibium, Sb; synonym Antimonium) — VA chemical element of group of a periodic system of D. I. Mendeleyev; in medicine of compound of antimony use as pharmaceuticals. Metal S. is applied in nonferrous metallurgy, at production of accumulators, in production of semiconductors, ball-bearings (bearing metals — babbits — represent alloy C. with tin, lead and copper), during the curing and coloring of rubber, in pyrotechnics. Connections C. — antimonides — use in computing devices, as filters and registrars of infrared radiation, at production of high-quality diodes and triodes, solar batteries, etc. Antimony and its connections represent professional harm for working at productions where the contact with dust and metal S.'s couples of, dust of the minerals containing S., etc.

S. is known to people from an extreme antiquity is possible. In the east natural Sb gray antimony 2 S 3 used as cosmetic; connections C. widely applied with the medical purposes. Properties C. and ways of its receiving were in detail described in 1604 by Vasily Valentine.

S.'s maintenance in crust makes 4*10 - 5  % on weight. Contains in a human body apprx. 7,9*10 - 3 S. Kontsentration S. in blood makes apprx. 4,6*10 - 6 . The tendency to selective accumulation of S. in separate bodies and fabrics is not revealed. S.'s concentration in a liver only twice, and in kidneys is only 3 times higher, than on average on all organism. Slightly higher S.'s concentration in a spleen.

The major mineral C. is gray antimony (stibnite, or antimonite). In S.'s nature represents mix of two stable isotopes: 121Sb (57,25%) and 123Sb (42,75%). More than 25 radionuclides C are artificially received. Practical value have 122Sb (T1/2 = 2,8 days) and 124 Sb (T1/2 = 60 days), to-rye use in sources at - radiations and sources of neutrons.

Page — silver-white brilliant brittle metal, t°pl 630,5 °, t°kip 1635 °, specific resistance 43,045*10 - 6 ohm / cm. On air at the room temperature S. is steady, during the heating reacts with halogens, nitric to - that, oxygen. At contact with alkaline liquids C. it is slowly dissolved. S.'s penetration into an organism at its hit on sweaty skin is explained by it. In connections C. shows hl. obr. valencies +5, + Z and — 3. With alkalis oxide of Sb203 antimony forms salts antimonites, e.g. NaSb02-3H20, and Sb205 oxide — antimonates, e.g. Na3Sb03-3H20. Formation of soluble complex compound C. with wine to - that KSb(C4H2O6) (OH) 2-0,5 H20 (so-called potassium antimonyl tartrat) is characteristic. The page forms gaseous hydride SbH3 stibine, are known also antimony-organic compounds (see. Organometallic compounds).

In biol. substrates C. find by means of reaction of formation of an antimonial mirror. Colorimetric methods of determination of content of S. in objects of the environment and in biol. substrates are based on ability of anions C. to form complex connections with the main organic dyes (methyl or crystal violet, diamond or malachite green). The painted complex is extracted from solution benzene or toluene with the subsequent kolorimetrirovaniye (see. Colorimetry ). Test-sensitivity of 0,05 mkg. Also the method of definition of S. by means of an atomnoabsorbtsionny spektrofotometriya gains distribution (see).

S.'s role in a metabolism at the person and animals is not established. Believe that it is not a biogenic microelement. Come to a human body of connection C. preferential with vegetable food, and also with inhaled air. Trivalent S. is removed by hl. obr. with a stake, and pentavalent — with urine. At the increased S.'s arrival the main quantity it is brought out of an organism in 5 — 7 days. S.'s ability to connect sulphhydryl groups (see) proteins, including and SH enzymes, leads to disturbance of the enzymatic processes catalyzed by these enzymes. S.'s removal from an organism accelerates after use of sulfur-containing drugs (e.g., Unithiolum). Sulfides C. in itself are less poisonous, than other its connections. Trivalent S.'s connections are more poisonous, than pentavalent S.'s connections as bonds of Sb (III) with sulfur are stronger. Connections C. by about 50 times are less dangerous from the point of view of their toxic action, than connection arsenic (see) and lead (see).

Professional harm

Under production conditions danger to working is constituted by vapors and metal S.'s dust, dust of minerals C. and its connections, and also stibine — the SbH3 stibine which is formed at metal S.'s receiving and other metals. Individual sensitivity of an organism to S. plays a part in development of intoxication, however on considerable exposures signs of harmful action of S. note at the majority working in contact with it or with its connections. The main displays of intoxication of S. connect with bystry distribution of ions of this metal on all organism, disorganization under their action of protein and carbohydrate metabolism. Believe that the residual number of S. a long time can be in an organism in the form of the proteinaceous and antimony complexes having unsharply expressed sensibilizing properties.

At hron. S.'s poisoning among miners of antimonial mines and metallurgists cases of antimonial are registered pneumoconiosis (see) — an anti-monoconiosis, a stibnoz, a sili-koantimonoz. Usually the disease has the diffusion and sclerous form with the expressed sklerozirovaniye radical limf, nodes, the tendency to progressing of a disease after the termination of contact

with dust C. is expressed poorly. At hron. S.'s poisoning inflammatory diseases of upper respiratory tracts — bronchitis (see), tracheitis are possible (see), and also conjunctivitis (see), stomatitis (see), on gingivas the bluish border sometimes appears. Note disturbances from c. N of page (sleeplessness, headaches, dizzinesses, the general weakness), hypothalamic syndromes (see). In more hard cases polyneurites, cardiovascular diseases are possible. At workers of antimonial steel works the general and gynecologic incidence which is a little increased in comparison with control is revealed, at them note disturbances of menstrual and genital functions.

At contact with S.'s aerosols and its connections skin diseases, with an itch and a xeroderma are frequent, note emergence erity, sometimes — pustular rash, eczema. Nek-ry researchers consider skin displays of intoxication of S. specific reaction of an organism to local influence of antimonial dust.

Treatment at hron. S.'s intoxications symptomatic.

At acute poisoning with couples and S.'s aerosols and its connections there comes the sharp irritation of upper respiratory tracts, conjunctivas of eyes, opacification of a cornea. Inhalation of aerosols of the oxides C. which are formed in the course of S.'s melting or at combustion of antimonial paints can cause the phenomenon of antimonial foundry fever (see). At household poisonings with the food cooked in the enameled ware glazed by the enamel containing S. observe the picture similar about a wedge, a picture of acute food toxicoinfection (see Toxicoinfections food).

First aid and emergency treatment

At acute poisoning with couples and S.'s aerosols appoint alkaline inhalations, plentiful drink (warm sweet tea or coffee), acetilsalicylic to - that, pyramidon. At acute peroral poisoning of S. repeated gastric lavages solution of a tannin and proteinaceous water are necessary. Inside give mucous broths, warm milk. At often repeating vomiting recommend to swallow of pieces of ice, Aeronum; subcutaneously enter morphine. The BALL and Unithiolum work as antidote only at poisoning of Sb (III). According to indications apply cardiovascular means. Further treatment — symptomatic.

Measures of prevention of a stibialism and its connections. Preventive actions shall provide a complete elimination of release of dust and vapors C. and its connections in air of workrooms. Automation and sealing of the equipment on the corresponding productions is necessary. At metal S.'s receiving and its connections preference shall be given to hydrometallurgical methods. Antidust suits (see Clothes special), safety spectacles (see), respirators belong to individual protection equipment (see). Preliminary and periodic medical examinations are of great importance (see. Medical examination) with an obligatory blood analysis, urine and a calla on the maintenance of Page.

Maximum allowable concentrations. Maximum one-time maximum allowable concentration for metal S.'s dust in air of a working zone of 0,5 mg/m3 (srednesmenny maximum allowable concentration of 0,2 mg/m3), maximum allowable concentration of oxides and Sb (III) sulfides — 1 mg/m3, oxides and Sb (V) sulfides — 2 mg/m3 (in terms of S.), fluorides and chlorides of antimony — 0,3 mg/m3 (in terms of S.). In water of reservoirs of economic and drinking and cultural and community water use of maximum allowable concentration Sb(III) it is equal to 0,05 mg/l.

Drugs of antimony

In medical practice as pharmaceuticals are used by organic compounds of three - and pentavalent S. K to domestic drugs of trivalent S. tartrate (see), and belongs to pentavalent S.'s drugs of antimonyl-sodium — Solusurminum (see). Abroad the greatest distribution from trivalent S.'s drugs was gained antimonyl-potassium tartrate (a synonym potassium antimonyl tartrat) and stibofen (a synonym fuadin), from pentavalent S.'s drugs — stibozan, stibozamin (a synonym Neostibosanum), stibenit also other drugs close to Solusurminum on action, but different from it on chemical structure.

Drugs C. have the expressed anthelmintic and anti-protozoan properties. Anthelmintic effect of drugs C. most clearly is shown at shistosomatoza (see). The mechanism of anthelmintic effect of drugs C. is connected with their ability to break carbohydrate metabolism shistosy at the expense of inhibition of enzyme of a fosfofruktokinaza (KF 2. 7. 1. 11). At the person and hematothermal animals in comparison with shistosoma sensitivity of this enzyme to drugs C. is many times lower that, obviously, caused rather sharp selectivity of drugs of this group concerning these helminths. The mechanism of antiprotozoan effect of drugs C. is similar to the mechanism of effect of drugs of arsenic. Drugs C. have ability to suppress life activity of nek-ry protozoa (e.g., leyshmaniye) by blockade of their SH enzymes. On pharmakol. to properties drugs C. are similar to drugs of arsenic and differ from the last in only more expressed local irritative action and smaller ability to cumulation. Trivalent S.'s drugs considerably surpass drugs in degree of toxicity and force of local irritative action pentavalent by Page.

From went. - kish. a path drugs C. (especially S. trivalent) are soaked up slowly. Owing to irritant action went on a mucous membrane. - kish. a path drugs of this group at intake in small doses reflex cause expectorant effect, and in high doses — vomiting. At parenteral administration drugs C. are rather quickly soaked up in blood and hl are deposited. obr. in cells of system of mononuclear phagocytes (see) and in parenchymatous bodies. S.'s allocation happens preferential through kidneys. In small amounts drugs C. are emitted with excretory glands. Assume that pentavalent S.'s drugs in an organism partially turn into more active connections of trivalent S. Imeyutsya also this that trivalent S.'s connections in an organism are partially metabolized with formation of the oxide C. differing high biol. activity and toxicity.

As helminthicides use antimonyl-sodium tartrate and other drugs trivalent Page. These drugs are used by hl. obr. for treatment of shi-stosomatoz. In the past as expectorating and vomitive applied also antimonyl-potassium tartrate. Solusurminum and other drugs of pentavalent S. use generally for chemotherapy visceral and nek-ry other forms of a skin leushmaniosis (e.g., a tuberculoid form).

Side effect of drugs C. is shown by the general weakness, arthralgias, mialgiya, a headache, nausea, vomiting, fervescence, skin rashes. At hypodermic and intramuscular introduction of Solusurminum there is pain in the field of an injection, formation of painful infiltrates is possible. Antimonyl-sodium tartrate can cause phlebitis. Accidental hit of solutions of this drug under skin causes sharp morbidity and hypostasis of fabrics.

At overdose of drugs C. there are metal taste in a mouth, an arthralgia, cough, conjunctivitis, hypersalivation, nausea, vomiting, a diarrhea, abdominal pains, muscular weakness, a bronchospasm, decrease in the ABP, a hypoglycemia. In hard cases the collapse and the phenomena of heart failure develops.

Bibliography: Gudzovsky G. A. Occupational health in production of antimony and its connections, Frunze, 1965; H e m about the Dr. at to A. A. Analytical chemistry of antimony, M., 1978, bibliogr.; Re mi G. Kurs of inorganic chemistry, the lane with it., t. 1, page 638, M., 1972; Antimony, under the editorship of S. M. Melnikov, M., 1977; Curtes J. P., De vel ay P. e t P a u-m a r d C. La stibiose,& pneumopathie due l'antimoine, arguments en faveur de son individualisation et de sa r6paration, Arch. Mai. prof., t. 40, p. 899, 1979; E 1 - 1 e r P. M. a. H an a r t z J. C. Sampling and analytical methods for antimony and its compounds, Amer. industr. Hyg. Ass. J., v. 39, p. 790, 1978; The pharmacological basis of therapeutics, ed. by A. G. Gilman a. o., p. 1029, 1074, N. Y., 1980.

A. V. Babkov; G. A. Gudzovsky (gigabyte.), V. K. Muratov (pharm.)