Mercury (element): Difference between revisions

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{{Elementbox_header | number=80 | symbol=Hg | name=mercury | left=[[gold]] | right=[[thallium]] | above=[[cadmium|Cd]] | below=[[ununbium|Uub]] | color1=#ffc0c0 | color2=blue }}
{{DrugProjectFormSinglePage
{{Elementbox_series | [[transition metal]]s }}
|authorTag=<!--Overview-->
{{Elementbox_groupperiodblock | group=12 | period=6 | block=d }}
|aOrAn=a
{{Elementbox_appearance_img | Hg_Mercury| silvery }}
|hasBlackBoxWarning=Yes
{{Elementbox_atomicmass_gpm | 200.59[[List of elements by atomic mass|(2)]] }}
|adverseReactions=<!--Black Box Warning-->
{{Elementbox_econfig | &#91;[[xenon|Xe]]&#93; 4f<sup>14</sup> 5d<sup>10</sup> 6s<sup>2</sup>}}
|blackBoxWarningTitle=<span style="color:#FF0000;">ConditionName: </span>
{{Elementbox_epershell | 2, 8, 18, 32, 18, 2 }}
|blackBoxWarningBody=<i><span style="color:#FF0000;">ConditionName: </span></i>
{{Elementbox_section_physicalprop | color1=#ffc0c0 | color2=blue }}
 
{{Elementbox_phase | [[liquid]] }}
* Content
{{Elementbox_density_gpcm3nrt | (liquid) 13.534 }}
 
{{Elementbox_meltingpoint | k=234.32 | c=-38.83 | f=-37.89 }}
<!--Adult Indications and Dosage-->
{{Elementbox_boilingpoint | k=629.88 | c=356.73 | f=674.11 }}
 
{{Elementbox_criticalpoint | k=1750 | mpa=172.00 }}
<!--FDA-Labeled Indications and Dosage (Adult)-->
{{Elementbox_heatfusion_kjpmol | 2.29 }}
|fdaLIADAdult======Condition1=====
{{Elementbox_heatvaporiz_kjpmol | 59.11 }}
 
{{Elementbox_heatcapacity_jpmolkat25 | 27.983 }}
* Dosing Information
{{Elementbox_vaporpressure_katpa | 315 | 350 | 393 | 449 | 523 | 629 | comment= }}
 
{{Elementbox_section_atomicprop | color1=#ffc0c0 | color2=blue }}
:* Dosage
{{Elementbox_crystalstruct | rhombohedral }}
 
{{Elementbox_oxistates | '''2''' (mercuric), 1 (mercurous)<br />(mildly [[base (chemistry)|basic]] oxide) }}
=====Condition2=====
{{Elementbox_electroneg_pauling | 2.00 }}
 
{{Elementbox_ionizationenergies3 | 1007.1 | 1810 | 3300 }}
* Dosing Information
{{Elementbox_atomicradius_pm | 150 }}
 
{{Elementbox_atomicradiuscalc_pm | 171 }}
:* Dosage
{{Elementbox_covalentradius_pm | 149 }}
 
{{Elementbox_vanderwaalsrad_pm | 155 }}
=====Condition3=====
{{Elementbox_section_miscellaneous | color1=#ffc0c0 | color2=blue }}
 
{{Elementbox_magnetic | [[diamagnetism|diamagnetic]] }}
* Dosing Information
{{Elementbox_eresist_ohmm | (25 °C) 961 n}}
 
{{Elementbox_thermalcond_wpmkat300k | 8.30 }}
:* Dosage
{{Elementbox_thermalexpansion_umpmkat25 | 60.4 }}
 
{{Elementbox_speedofsound_mps | (liquid, 20 °C) 1451.4 }}
=====Condition4=====
{{Elementbox_cas_number | 7439-97-6 }}
 
{{Elementbox_isotopes_begin | color1=#ffc0c0 | color2=blue }}
* Dosing Information
{{Elementbox_isotopes_decay | mn=194 | sym=Hg
 
| na=[[synthetic radioisotope|syn]] | hl=444 y
:* Dosage
| dm=[[electron capture|ε]] | de=0.040 | pn=194 | ps=[[gold|Au]] }}
 
{{Elementbox_isotopes_decay | mn=195 | sym=Hg
<!--Off-Label Use and Dosage (Adult)-->
| na=[[synthetic radioisotope|syn]] | hl=9.9 h
 
| dm=[[electron capture|ε]] | de=1.510 | pn=195 | ps=[[gold|Au]] }}
<!--Guideline-Supported Use (Adult)-->
{{Elementbox_isotopes_stable | mn=196 | sym=Hg | na=0.15% | n=116 }}
|offLabelAdultGuideSupport======Condition1=====
{{Elementbox_isotopes_decay | mn=197 | sym=Hg
 
| na=[[synthetic radioisotope|syn]] | hl=64.14 h
* Developed by:
| dm=[[electron capture|ε]] | de=0.600 | pn=197 | ps=[[gold|Au]] }}
 
{{Elementbox_isotopes_stable | mn=198 | sym=Hg | na=9.97% | n=118 }}
* Class of Recommendation:
{{Elementbox_isotopes_stable | mn=199 | sym=Hg | na=16.87% | n=119 }}
 
{{Elementbox_isotopes_stable | mn=200 | sym=Hg | na=23.1% | n=120 }}
* Strength of Evidence:
{{Elementbox_isotopes_stable | mn=201 | sym=Hg | na=13.18% | n=121 }}
 
{{Elementbox_isotopes_stable | mn=202 | sym=Hg | na=29.86% | n=122 }}
* Dosing Information
{{Elementbox_isotopes_decay | mn=203 | sym=Hg
 
| na=[[synthetic radioisotope|syn]] | hl=46.612 d
:* Dosage
| dm=[[beta emission|β]]<sup>-</sup> | de=0.492 | pn=203 | ps=[[thallium|Tl]] }}
 
{{Elementbox_isotopes_stable | mn=204 | sym=Hg | na=6.87% | n=124 }}
=====Condition2=====
{{Elementbox_isotopes_end}}
 
{{Elementbox_footer | color1=#ffc0c0 | color2=blue
There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
}}
 
{{CMG}}
<!--Non–Guideline-Supported Use (Adult)-->
|offLabelAdultNoGuideSupport======Condition1=====
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
 
<!--Pediatric Indications and Dosage-->
 
<!--FDA-Labeled Indications and Dosage (Pediatric)-->
|fdaLIADPed======Condition1=====
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>FDA-Labeled Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Off-Label Use and Dosage (Pediatric)-->
 
<!--Guideline-Supported Use (Pediatric)-->
|offLabelPedGuideSupport======Condition1=====
 
* Developed by:
 
* Class of Recommendation:
 
* Strength of Evidence:
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Non–Guideline-Supported Use (Pediatric)-->
|offLabelPedNoGuideSupport======Condition1=====
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Contraindications-->
|contraindications=* Condition1
 
<!--Warnings-->
|warnings=* Description
 
====Precautions====
 
* Description
 
<!--Adverse Reactions-->
 
<!--Clinical Trials Experience-->
|clinicalTrials=There is limited information regarding <i>Clinical Trial Experience</i> of {{PAGENAME}} in the drug label.
 
=====Body as a Whole=====
 
 
 
 
=====Cardiovascular=====
 
 
 
 
=====Digestive=====
 
 
 
 
=====Endocrine=====
 
 
 
 
=====Hematologic and Lymphatic=====
 
 
 
 
=====Metabolic and Nutritional=====
 
 
 
 
=====Musculoskeletal=====
 
 
 
 
=====Neurologic=====
 
 
 
 
=====Respiratory=====
 
 
 
 
=====Skin and Hypersensitivy Reactions=====
 
 
 
 
=====Special Senses=====
 
 
 
 
=====Urogenital=====
 
 
 
 
=====Miscellaneous=====
 
 
 
<!--Postmarketing Experience-->
|postmarketing=There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label.
 
=====Body as a Whole=====
 
 
 
=====Cardiovascular=====
 
 
 
=====Digestive=====
 
 
 
=====Endocrine=====
 
 
 
=====Hematologic and Lymphatic=====
 
 
 
=====Metabolic and Nutritional=====
 
 
 
=====Musculoskeletal=====
 
 
 
=====Neurologic=====
 
 
 
=====Respiratory=====
 
 
 
=====Skin and Hypersensitivy Reactions=====
 
 
 
=====Special Senses=====
 
 
 
=====Urogenital=====
 
 
 
=====Miscellaneous=====
 
 
 
<!--Drug Interactions-->
|drugInteractions=* Drug
:* Description
 
<!--Use in Specific Populations-->
|useInPregnancyFDA=* '''Pregnancy Category'''
|useInPregnancyAUS=* '''Australian Drug Evaluation Committee (ADEC) Pregnancy Category'''


There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of {{PAGENAME}} in women who are pregnant.
|useInLaborDelivery=There is no FDA guidance on use of {{PAGENAME}} during labor and delivery.
|useInNursing=There is no FDA guidance on the use of {{PAGENAME}} with respect to nursing mothers.
|useInPed=There is no FDA guidance on the use of {{PAGENAME}} with respect to pediatric patients.
|useInGeri=There is no FDA guidance on the use of {{PAGENAME}} with respect to geriatric patients.
|useInGender=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific gender populations.
|useInRace=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific racial populations.
|useInRenalImpair=There is no FDA guidance on the use of {{PAGENAME}} in patients with renal impairment.
|useInHepaticImpair=There is no FDA guidance on the use of {{PAGENAME}} in patients with hepatic impairment.
|useInReproPotential=There is no FDA guidance on the use of {{PAGENAME}} in women of reproductive potentials and males.
|useInImmunocomp=There is no FDA guidance one the use of {{PAGENAME}} in patients who are immunocompromised.


<!--Administration and Monitoring-->
|administration=* Oral


==Overview==
* Intravenous
'''Mercury'''({{IPAEng|ˈmɜrkjʊri}}), also called '''quicksilver''', is a [[chemical element]] with the symbol '''Hg''' (Latinized ''hydrargyrum'', meaning ''watery'' or ''liquid'' ''silver'') and [[atomic number]] 80. A heavy, silvery [[d-block]] [[metal]], mercury is one of five elements that are [[liquid]] at or near [[room temperature]] and pressure.<ref>{{cite web|url=http://antoine.frostburg.edu/chem/senese/101/inorganic/faq/why-is-mercury-liquid.shtml|title=Why is mercury a liquid at STP?|accessdaymonth=1 May|accessyear=2007|publisher=General Chemistry Online at Frostburg State University|author=Fred Senese}}</ref> The others are the metals [[caesium]], [[francium]], and [[gallium]], and the non-metal [[bromine]]. Of these, only mercury and bromine are liquids at [[standard conditions for temperature and pressure]].  
|monitoring=There is limited information regarding <i>Monitoring</i> of {{PAGENAME}} in the drug label.


Mercury is used in thermometers, barometers, manometers, sphygmomanometers, float valves, and other scientific apparatus, though concerns about the element's toxicity have led to mercury thermometers and sphygmomanometers being largely phased out in clinical environments in favour of [[alcohol]]-filled, digital, or thermistor-based instruments. It remains in use in a number of other ways in scientific and scientific research applications, and in [[dental restoration|dental amalgam]]. Mercury is mostly obtained by reduction from the [[mineral]] cinnabar.
* Description


Mercury occurs in deposits throughout the world and it is harmless in an insoluble form, such as mercuric sulfide, but it is poisonous in soluble forms such as [[mercuric chloride]] or [[methylmercury]].
<!--IV Compatibility-->
|IVCompat=There is limited information regarding <i>IV Compatibility</i> of {{PAGENAME}} in the drug label.


== Applications ==
<!--Overdosage-->
[[Image:Barometer mercury column hg.jpg|thumb|right|Mercury column to measure pressure]]
|overdose====Acute Overdose===
Mercury is used primarily for the manufacture of industrial chemicals or for electrical and electronic applications. It is used in some [[thermometer]]s, especially ones which are used to measure high temperatures (In the United States, non-prescription sale of mercury fever thermometers is banned by a number of different states and localities). Other uses:
* Mercury is still used in some cultures for [[folk medicine]] and ceremonial purposes which may involve [[ingestion]], [[Injection (medicine)|injection]], or the sprinkling of elemental mercury around the home. It must be emphasized that the former two procedures, especially, are extremely


'''Historical uses:''' Mercury compounds have been used in [[antiseptic]]s, [[laxative]]s, [[antidepressant]]s, and in [[Syphilis|antisyphilitics]].
====Signs and Symptoms====


=== Dentistry ===
* Description
The element mercury is the main ingredient in [[amalgam|dental amalgams]]. Controversy over the [[health effects]] from the use of mercury amalgams began shortly after its introduction into the western world, nearly 200 years ago. In 1845, The [[American Society of Dental Surgeons]], concerned about mercury poisoning, asked its members to sign a pledge that they would not use amalgam. The ASDS disbanded in 1865. The [[American Dental Association]] formed three years after and currently takes the position that "amalgam is a valuable, viable and safe choice for dental patients,"<ref>{{cite web|url=http://www.ada.org/prof/resources/positions/statements/amalgam.asp|title=Statement on Dental Amalgam|publisher=American Dental Association|accessdaymonth=1 May|accessyear=2007}}</ref> In 1993, the [[United States Public Health Service]] reported that "amalgam fillings release small amounts of mercury vapor," but in such a small amount that it "has not been shown to cause any … adverse health effects". This position is not shared by all governments and there is an ongoing [[dental amalgam controversy]]. A recent review by an FDA-appointed advisory panel rejected, by a margin of 13-7, the current FDA report on amalgam safety, stating the report's conclusions were unreasonable given the quantity and quality of information currently available. Panelists said remaining uncertainties about the risk of so-called silver fillings demanded further research; in particular, on the effects of mercury-laden fillings on children and the fetuses of pregnant women with fillings, and the release of mercury vapor on insertion and removal of mercury fillings.


=== Medicine ===
====Management====
Mercury and its compounds have been used in medicine for centuries, although they are much less common today than they once were, now that the toxic effects of mercury and its compounds are more widely understood.


[[Mercury(I) chloride]] (also known as [[calomel]] or mercurous chloride) has traditionally been used as a [[diuretic]], topical [[disinfectant]], and [[laxative]]. [[Mercury(II) chloride]] (also known as mercuric chloride or corrosive sublimate) was once used to treat [[syphilis]] (along with other mercury compounds), although it is so toxic that sometimes the symptoms of its toxicity were confused with those of the syphilis it was believed to treat.<ref>Pimple, K.D. Pedroni, J.A. Berdon, V. (2002, July 09). [http://www.indiana.edu/~poynter/sas/lb/syphilis.html Syphilis in history]. Poynter Center for the Study of Ethics and American Institutions at Indiana University-Bloomington. Retrieved on April 17, 2005.</ref> It was also used as a disinfectant. [[Blue mass]], a pill or syrup in which mercury is the main ingredient, was prescribed throughout the 1800s for numerous conditions including constipation, depression, child-bearing and toothaches.<ref>{{cite journal|url=http://news.nationalgeographic.com/news/2001/07/0717_lincoln.html|journal=National Geographic|title=Did Mercury in "Little Blue Pills" Make Abraham Lincoln Erratic?|date=[[July 17]], [[2001]]|accessdaymonth=1 May|accessyear=2007|author=Hillary Mayell}}</ref> In the early 20th century, mercury was administered to children yearly as a laxative and dewormer, and it was used in teething powders for infants. The mercury containing organohalide [[Mercurochrome]] is still widely used but has been banned in some countries such as the U.S.
* Description


Since the 1930s some [[vaccine]]s have contained the preservative [[thiomersal]], which is metabolized or degraded to [[ethyl mercury]]. Although it was [[Thiomersal controversy|widely speculated]] that this mercury-based preservative can cause or trigger [[autism]] in children, scientific studies showed no evidence supporting any such link.<ref>{{cite journal |journal=Pediatrics |year=2004 |volume=114 |issue=3 |pages=793–804 |title= Thimerosal-containing vaccines and autistic spectrum disorder: a critical review of published original data |author= Parker SK, Schwartz B, Todd J, Pickering LK |doi=10.1542/peds.2004-0434 |pmid=15342856 |url=http://pediatrics.aappublications.org/cgi/content/full/114/3/793}} [http://pediatrics.aappublications.org/cgi/content/full/115/1/200 Erratum] (2005). ''Pediatrics'' '''115''' (1): 200. {{DOI|10.1542/peds.2004-2402}} PMID 15630018.</ref> Nevertheless thiomersal has been removed from or reduced to trace amounts in all U.S. vaccines recommended for children 6 years of age and under, with the exception of inactivated influenza vaccine.<ref>{{cite web |date=[[2007-09-06]] |url=http://www.fda.gov/cber/vaccine/thimerosal.htm |accessdate=2007-10-01 |title= Thimerosal in vaccines |publisher= Center for Biologics Evaluation and Research, U.S. Food and Drug Administration}}</ref>
===Chronic Overdose===


Mercury in the form of one of its common ores, [[cinnabar]], remains an important component of [[Traditional Chinese Medicine|Chinese]], [[Tibetan medicine|Tibetan]], and [[Ayurveda|Ayurvedic]] medicine. As problems may arise when these medicines are exported to countries that prohibit the use of mercury in medicines, in recent times, less toxic substitutes have been devised.
There is limited information regarding <i>Chronic Overdose</i> of {{PAGENAME}} in the drug label.


Today, the use of mercury in medicine has greatly declined in all respects, especially in developed countries. Thermometers and [[sphygmomanometer]]s containing mercury were invented in the early 18th and late 19th centuries, respectively. In the early 21st century, their use is declining and has been banned in some countries, states and medical institutions. In 2002, the U.S. Senate passed legislation to phase out the sale of [[Medical prescription|non-prescription]] mercury thermometers. In 2003, Washington and Maine became the first states to ban mercury blood pressure devices.<ref>{{cite web|url=http://www.noharm.org/details.cfm?type=document&ID=782|title=Two States Pass First-time Bans on Mercury Blood Pressure Devices|date=[[June 2]], [[2003]]|publisher=Health Care Without Harm|accessdaymonth=1 May|accessyear=2007}}</ref> Mercury compounds are found in some [[over-the-counter drug]]s, including topical [[antiseptics]], stimulant [[laxative]]s, [[diaper rash|diaper-rash]] [[ointment]], [[eye drops]], and [[nasal spray]]s. The [[Food and Drug Administration|FDA]] has “inadequate data to establish general recognition of the safety and effectiveness,” of the mercury ingredients in these products.<ref>{{cite web|url=http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=310.545&SearchTerm=mercury| title=Title 21—Food and Drugs Chapter I—Food and Drug Administration Department of Health and Human Services Subchapter D—Drugs for Human Use Code of federal regulations|publisher=United States Food and Drug Administration|accessdaymonth=1 May|accessyear=2007}}</ref> Mercury is still used in some diuretics, although substitutes now exist for most therapeutic uses.
<!--Pharmacology-->


== Isotopes ==
<!--Drug box 2-->
There are seven stable [[isotope]]s of mercury with Hg-202 being the most abundant (29.86%). The longest-lived [[radioisotope]]s are <sup>194</sup>Hg with a [[half-life]] of 444 years, and <sup>203</sup>Hg with a half-life of 46.612 days. Most of the remaining radioisotopes have half-lives that are less than a day. <sup>199</sup>Hg and <sup>201</sup>Hg are the most often studied [[Nuclear magnetic resonance|NMR]]-active nuclei, having spins of 1/2 and 3/2 respectively.
|drugBox=<!--Mechanism of Action-->
|mechAction=*


== Compounds ==
<!--Structure-->
The most important salts are
|structure=*  
* [[Mercury(I) chloride]] (AKA [[calomel]]) is sometimes still used in [[medicine]] and acousto-optical filters;
* [[Mercury(II) chloride]] (which is very [[corrosion|corrosive]], [[sublimation (chemistry)|sublimates]] and is a violent poison);


== Safety ==
: [[File:{{PAGENAME}}01.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]
{{see also|mercury poisoning}}
[[Image:Skull and crossbones.svg|left|40px]]
Mercury and most of its compounds are extremely toxic and are generally handled with care; in cases of spills involving mercury (such as from certain thermometers or fluorescent light bulbs) specific cleaning procedures are used to avoid toxic exposure.<ref>{{cite web|url=http://www.epa.gov/mercury/spills/index.htm|title=Mercury: Spills, Disposal and Site Cleanup|publisher=Environmental Protection Agency|accessdate=2007-08-11}}</ref>  It can be inhaled and absorbed through the skin and mucous membranes, so containers of mercury are securely sealed to avoid spills and evaporation. Heating of mercury, or compounds of mercury that may decompose when heated, is always carried out with adequate ventilation in order to avoid exposure to mercury vapor. The most toxic forms of mercury are its [[organic compounds]], such as [[dimethylmercury]] and [[methylmercury]]. 


=== Occupational exposure ===
<!--Pharmacodynamics-->
Due to the health effects of mercury exposure, industrial and commercial uses are regulated in many countries. The [[World Health Organization]], OSHA, and [[NIOSH]] all treat mercury as an occupational hazard, and have established specific occupational exposure limits. Environmental releases and disposal of mercury are regulated in the U.S. primarily by the [[United States Environmental Protection Agency]].
|PD=There is limited information regarding <i>Pharmacodynamics</i> of {{PAGENAME}} in the drug label.


Case control studies have shown effects such as tremors, impaired cognitive skills, and sleep disturbance in workers with chronic exposure to mercury vapour even at low concentrations in the range 0.7–42 μg/m<sup>3</sup>.<ref name="ngim">{{cite journal|author=Ngim CH, Foo SC, Boey KW, and Keyaratnam J | title=Chronic neurobehavioral effects of elemental mercury in dentists | journal=British Journal of Industrial Medicine | volume=49 | pages=782-790 | year=1992}}</ref><ref name="liang">{{cite journal|author=Liang YX, Sun RK, Chen ZQ, and Li LH | title=Psychological effects of low exposure to mercury vapor: Application of computer-administered neurobehavioral evaluation system | journal=Environmental Research | volume=60 | pages=320-327}}</ref>
<!--Pharmacokinetics-->
|PK=There is limited information regarding <i>Pharmacokinetics</i> of {{PAGENAME}} in the drug label.


A study has shown that acute exposure (4-8 hours) to calculated elemental mercury levels of 1.1 to 44 mg/m<sup>3</sup> resulted in chest pain, [[dyspnea]], cough, [[hemoptysis]], impairment of pulmonary function, and evidence of interstitial [[pneumonitis]].<ref>McFarland, RB and H. Reigel. J Occup Med. 1978 Aug;20(8):532-4.</ref>
<!--Nonclinical Toxicology-->
|nonClinToxic=There is limited information regarding <i>Nonclinical Toxicology</i> of {{PAGENAME}} in the drug label.


Acute exposure to mercury vapor has been shown to result in profound central nervous system effects, including psychotic reactions characterized by delirium, hallucinations, and suicidal tendency. Occupational exposure has resulted in broad-ranging functional disturbance, including [[erethism]], irritability, excitability, excessive shyness, and insomnia. With continuing exposure, a fine tremor develops and may escalate to violent muscular spasms. Tremor initially involves the hands and later spreads to the eyelids, lips, and tongue. Long-term, low-level exposure has been associated with more subtle symptoms of erethism, including fatigue, irritability, loss of memory, vivid dreams, and depression.<ref>WHO (1976) Environmental Health Criteria 1: Mercury, Geneva, World Health Organization, 131 pp.</ref><ref>WHO. Inorganic mercury. Environmental Health Criteria 118. World Health Organization, Geneva, 1991.</ref>
<!--Clinical Studies-->
|clinicalStudies=There is limited information regarding <i>Clinical Studies</i> of {{PAGENAME}} in the drug label.


===Treatment===
<!--How Supplied-->
Research on the treatment of mercury poisoning is limited. Currently available drugs for acute mercurial poisoning include chelators N-acetyl-D,L-penicillamine (NAP), British Anti-Lewisite (BAL), [[2,3-dimercapto-1-propanesulfonic acid]] (DMPS), and [[dimercaptosuccinic acid]] (DMSA). In one small study including 11 construction workers exposed to elemental mercury, patients were treated with DMSA and NAP.<ref>Bluhm, RE, et. Al. Hum Exp Toxicol 1992 May;11(3):201-10.</ref> Chelation therapy with both drugs resulted in the mobilization of a small fraction of the total estimated body mercury. DMSA was able to increase the excretion of mercury to a greater extent than NAP.
|howSupplied=*
|packLabel=<!--Patient Counseling Information-->
|fdaPatientInfo=There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.


=== Mercury in fish ===
<!--Precautions with Alcohol-->
[[Image:WarningMercurySign.jpg|thumb|right|California sign warning about the risks from mercury-containing fish.]]
|alcohol=* Alcohol-{{PAGENAME}} interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Fish and shellfish have a natural tendency to concentrate mercury in their bodies, often in the form of [[methylmercury]], a highly toxic organic compound of mercury. Species of fish that are high on the food chain, such as shark, swordfish, king mackerel, albacore tuna, and tilefish contain higher concentrations of mercury than others. This is because mercury is stored in the muscle tissues of fish, and when a predatory fish eats another fish, it assumes the entire body burden of mercury in the consumed fish. Since fish are less efficient at depurating than accumulating methylmercury, fish-tissue concentrations increase over time. Thus species that are high on the food chain amass body burdens of mercury that can be ten times higher, or more, than the species they consume. This process is called biomagnification. The first occurrence of widespread [[mercury poisoning]] in humans occurred this way in Minamata, Japan, now called [[Minamata disease]].


The complexities associated with mercury fate and transport are relatively succinctly described by USEPA in their 1997 Mercury Study Report to Congress. Because methylmercury and high levels of elemental mercury can be particularly toxic to unborn or young children, organizations such as the [[United States Environmental Protection Agency|U.S. EPA]] and FDA recommend that women who are pregnant or plan to become pregnant within the next one or two years, as well as young children avoid eating more than 6 ounces (one average meal) of fish per week.<!--
<!--Brand Names-->
--><ref>{{cite web | title = What You Need to Know About Mercury in Fish and Shellfish | author = FDA/EPA | accessdaymonth = 25 October|accessyear= 2006 | year = 2004 | url = http://www.cfsan.fda.gov/~dms/admehg3.html}}</ref><!-- dan the image didn't work
|brandNames=* ®<ref>{{Cite web | title = | url = }}</ref>


--> In the United States the FDA has an action level for methyl mercury in commercial marine and freshwater fish that is 1.0 parts per million (ppm), and in Canada the limit for the total of mercury content is 0.5 ppm.
<!--Look-Alike Drug Names-->
|lookAlike=* A® — B®<ref name="www.ismp.org">{{Cite web  | last =  | first =  | title = http://www.ismp.org | url = http://www.ismp.org | publisher =  | date =  }}</ref>


Species with characteristically low levels of mercury include shrimp, tilapia, salmon, pollock, and catfish (FDA March 2004). The FDA characterizes shrimp, catfish, pollock, salmon, and canned light tuna as low-mercury seafood, although recent tests have indicated that up to 6 percent of canned light tuna may contain high levels.<ref>{{cite news|url=http://www.chicagotribune.com/features/health/chi-0601270193jan27,1,7450296.story|publisher=Chicago Tribune|date=[[January 27]], [[2006]]|title=FDA tests show risk in tuna|accessdate=2007-05-01}}</ref>
<!--Drug Shortage Status-->
|drugShortage=
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{{PillImage
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{{LabelImage
|fileName={{PAGENAME}}11.png
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{{LabelImage
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<!--Pill Image-->


== References ==
{{reflist|2}}


==Additional Resources==


{{refbegin}}
<!--Label Display Image-->
* Kolev, S.T. Bates, N. ''[http://www.intox.org/databank/documents/chemical/mercury/ukpid27.htm Mercury (UK PID)].'' National Poisons Information Service: Medical Toxicology Unit (London Centre).
* Jahn, Robert G. "Physics of Electric Propulsion"  McGraw-Hill Series in Missile and Space Technology, McGraw-Hill, (1968)
{{refend}}


== External links ==
* [http://toxnet.nlm.nih.gov/cgi-bin/sis/search/r?dbs+hsdb:@term+@rn+@rel+7439-97-6 NLM Hazardous Substances Databank &ndash; Mercury]
* [http://www.globalmercuryproject.org/ UNIDO/UNDP/GEM Global Mercury Project]
* [http://www.epa.gov/ostwater/fishadvice/advice.html EPA fish consumption guidelines]
* [http://www.atsdr.cdc.gov/tfacts46.html ATSDR &mdash; ToxFAQs™: Mercury]
* [http://www.webelements.com/webelements/elements/text/Hg/index.html WebElements.com &ndash; Mercury]
* [http://www.jtbaker.com/msds/englishhtml/m1599.htm Material Safety Data Sheet &ndash; Mercury]
* [http://www.theodoregray.com/PeriodicTable/Elements/080/index.s7.html Hg 80 Mercury]
* [http://www.chem.unep.ch/mercury/Report/Final%20Assessment%20report.htm Global Mercury Assessment report 2002] by the [[United Nations Environment Programme|UNEP]].
* [http://www.nrdc.org/health/effects/mercury/index.asp Natural Resources Defense Council (NRDC): Mercury Contamination in Fish guide] &mdash; [[NRDC]]


<br>




[[Category:Chemical elements]]
[[Category:Mercury (element)]]


[[ar:زئبق]]
<!--Category-->
[[ast:Mercuriu (elementu)]]
[[bn:পারদ (মৌল)]]
[[be:Ртуць]]
[[bs:Živa]]
[[bg:Живак]]
[[ca:Mercuri (element)]]
[[cs:Rtuť]]
[[co:Argentuvivu]]
[[cy:Mercwri]]
[[da:Kviksølv]]
[[de:Quecksilber]]
[[et:Elavhõbe]]
[[el:Υδράργυρος]]
[[es:Mercurio (elemento)]]
[[eo:Hidrargo]]
[[eu:Merkurio (elementua)]]
[[fa:جیوه]]
[[fr:Mercure (chimie)]]
[[fur:Mercuri (element)]]
[[ga:Mearcair (airgead beo)]]
[[gl:Mercurio (elemento)]]
[[ko:수은]]
[[hy:Սնդիկ]]
[[hr:Živa]]
[[io:Merkurio]]
[[id:Raksa]]
[[is:Kvikasilfur]]
[[it:Mercurio (elemento)]]
[[he:כספית]]
[[sw:Zebaki]]
[[ht:Mèki (eleman)]]
[[ku:Zîbeq]]
[[la:Hydrargentum]]
[[lv:Dzīvsudrabs]]
[[lb:Quecksëlwer]]
[[lt:Gyvsidabris]]
[[jbo:margu]]
[[hu:Higany]]
[[mi:Konuoi]]
[[ms:Raksa]]
[[nl:Kwik]]
[[ja:水銀]]
[[no:Kvikksølv]]
[[nn:Kvikksølv]]
[[oc:Mercuri (element)]]
[[nds:Quecksülver]]
[[pl:Rtęć]]
[[pt:Mercúrio (elemento químico)]]
[[qu:Yaku qullqi]]
[[ru:Ртуть]]
[[scn:Mercuriu (elementu chìmicu)]]
[[simple:Mercury (element)]]
[[sk:Ortuť (nerast)]]
[[sl:Živo srebro]]
[[sr:Жива]]
[[sh:Živa]]
[[fi:Elohopea]]
[[sv:Kvicksilver]]
[[ta:பாதரசம்]]
[[th:ปรอท]]
[[vi:Thủy ngân]]
[[tr:Cıva]]
[[uk:Ртуть]]
[[zh-yue:水銀]]
[[zh:汞]]


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Revision as of 20:20, 8 January 2015

Mercury (element)
Black Box Warning
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

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Black Box Warning

ConditionName:
See full prescribing information for complete Boxed Warning.
ConditionName:
  • Content

Overview

Mercury (element) is a {{{drugClass}}} that is FDA approved for the {{{indicationType}}} of {{{indication}}}. There is a Black Box Warning for this drug as shown here. Common adverse reactions include .

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Condition1
  • Dosing Information
  • Dosage
Condition2
  • Dosing Information
  • Dosage
Condition3
  • Dosing Information
  • Dosage
Condition4
  • Dosing Information
  • Dosage

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Mercury (element) in adult patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Mercury (element) in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding FDA-Labeled Use of Mercury (element) in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Mercury (element) in pediatric patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Mercury (element) in pediatric patients.

Contraindications

  • Condition1

Warnings

ConditionName:
See full prescribing information for complete Boxed Warning.
ConditionName:
  • Content
  • Description

Precautions

  • Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Mercury (element) in the drug label.

Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Mercury (element) in the drug label.

Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous

Drug Interactions

  • Drug
  • Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

  • Pregnancy Category


Pregnancy Category (AUS):

  • Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Mercury (element) in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Mercury (element) during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Mercury (element) with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Mercury (element) with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Mercury (element) with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Mercury (element) with respect to specific gender populations.

Race

There is no FDA guidance on the use of Mercury (element) with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Mercury (element) in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Mercury (element) in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Mercury (element) in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Mercury (element) in patients who are immunocompromised.

Administration and Monitoring

Administration

  • Oral
  • Intravenous

Monitoring

There is limited information regarding Monitoring of Mercury (element) in the drug label.

  • Description

IV Compatibility

There is limited information regarding IV Compatibility of Mercury (element) in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

  • Description

Management

  • Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Mercury (element) in the drug label.

Pharmacology

There is limited information regarding Mercury (element) Pharmacology in the drug label.

Mechanism of Action

Structure

File:Mercury (element)01.png
This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Mercury (element) in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Mercury (element) in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Mercury (element) in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Mercury (element) in the drug label.

How Supplied

Storage

There is limited information regarding Mercury (element) Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Mercury (element) |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Mercury (element) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Patient Counseling Information of Mercury (element) in the drug label.

Precautions with Alcohol

  • Alcohol-Mercury (element) interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Look-Alike Drug Names

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. ↑ Empty citation (help)
  2. ↑ "http://www.ismp.org". External link in |title= (help)

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