Arsine Poisoning Medication

Updated: Feb 23, 2023
  • Author: Kermit D Huebner, MD, FACEP; Chief Editor: Duane C Caneva, MD, MSc  more...
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Medication Summary

Diuresis with intravenous mannitol and urinary alkalinization with sodium bicarbonate may be of benefit prior to the onset of kidney failure.



Class Summary

These agents promote urine flow.

Mannitol (Osmitrol, Resectisol)

Increases osmotic pressure of glomerular filtrate, inducing an osmotic gradient that inhibits tubular resorption of water and electrolytes, resulting in increased urinary output.


Urinary alkalinization agents

Class Summary

These agents decrease risk of heme-pigment–induced renal injury from arsine-related hemolysis.

Sodium bicarbonate (Neut)

Dosing of sodium bicarbonate to induce urinary alkalinization not standardized; urinary alkalinization may prevent heme-pigment nephropathy by decreasing hemoglobin crystallization in renal tubules and/or by decreasing iron uptake by tubular epithelium.