Question:
N-acetyl penicillamine is used in the treatment of poisoning by which of the following?
N-acetyl penicillamine is used in the treatment of poisoning by which of the following?
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Think about which of these metals has no dedicated chelator, and which ones are classically paired with EDTA or dimercaprol instead.
Updated On: Jul 16, 2026
- Mercury
- Lead
- Cadmium
- Arsenic
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The Correct Option is A
Solution and Explanation
Step 1: Understanding the Question:
The question asks which heavy metal poisoning is treated with N-acetyl penicillamine, an oral chelating agent that binds metal ions through its sulfhydryl group so the complex can be excreted in urine.
Step 2: Key Concept or Approach:
Different heavy metals have their own preferred chelators. Lead poisoning is treated mainly with calcium disodium EDTA, dimercaprol (BAL), or succimer. Arsenic poisoning is treated with dimercaprol. Cadmium poisoning has no reliable chelator — dimercaprol is actually contraindicated because it forms a more nephrotoxic complex, so cadmium toxicity is managed supportively. Penicillamine, on the other hand, is an established oral option for chronic mercury poisoning when parenteral dimercaprol is not appropriate or when maintenance oral therapy is needed after initial treatment.
Step 3: Working Through the Options:
Mercury is correct because penicillamine has a recognised role as an oral chelator in mercury toxicity. Lead is incorrect because EDTA, dimercaprol, and succimer are the standard agents, with penicillamine only a distant second-line option. Cadmium is incorrect because no chelator, including penicillamine, is the standard treatment — cadmium toxicity is managed by removing exposure and supportive care. Arsenic is incorrect because dimercaprol is the chelator of choice, not penicillamine.
Step 4: Conclusion:
The correct answer is Mercury.
The question asks which heavy metal poisoning is treated with N-acetyl penicillamine, an oral chelating agent that binds metal ions through its sulfhydryl group so the complex can be excreted in urine.
Step 2: Key Concept or Approach:
Different heavy metals have their own preferred chelators. Lead poisoning is treated mainly with calcium disodium EDTA, dimercaprol (BAL), or succimer. Arsenic poisoning is treated with dimercaprol. Cadmium poisoning has no reliable chelator — dimercaprol is actually contraindicated because it forms a more nephrotoxic complex, so cadmium toxicity is managed supportively. Penicillamine, on the other hand, is an established oral option for chronic mercury poisoning when parenteral dimercaprol is not appropriate or when maintenance oral therapy is needed after initial treatment.
Step 3: Working Through the Options:
Mercury is correct because penicillamine has a recognised role as an oral chelator in mercury toxicity. Lead is incorrect because EDTA, dimercaprol, and succimer are the standard agents, with penicillamine only a distant second-line option. Cadmium is incorrect because no chelator, including penicillamine, is the standard treatment — cadmium toxicity is managed by removing exposure and supportive care. Arsenic is incorrect because dimercaprol is the chelator of choice, not penicillamine.
Step 4: Conclusion:
The correct answer is Mercury.
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