Pharmacokinetics
The absorption of
mercury varies considerably depending on the chemical form of the metal. Elemental
mercury is quite volatile and can be absorbed from the lungs (Table 57–1). It
is poorly absorbed from the intact gastrointestinal tract. Inhaled mercury is
the primary source of occupational exposure. Organic short-chain alkylmercury
compounds are volatile and potentially harmful by inhalation as well as by
ingestion. Percutaneous absorption of metallic mercury and inorganic mercury
can be of clinical concern following massive acute or long-term chronic
exposure. Alkylmercury compounds appear to be well absorbed through the skin,
and acute contact with a few drops of dimethylmercury has resulted in severe,
delayed toxicity. After absorption, mercury is distributed to the tissues
within a few hours, with the highest concentration occurring in the kidney.
Inorganic mercury is excreted through the urine and
feces. Excretion of inorganic mer-cury follows a multicompartment model: most
is excreted within weeks to months, but a fraction may be retained in the
kidneys and brain for years. After inhalation of elemental mercury vapor,
urinary mercury levels decline with a half-life of approximately 1–3 months.
Methylmercury, which has a blood and whole body half-life of approximately 50
days, undergoes biliary excretion and enterohepatic circulation, with more than
two thirds eventually excreted in the feces. Mercury binds to sulfhydryl groups
in kera-tinized tissue, and as with lead and arsenic, traces appear in the hair
and nails.
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