Trivalent inorganic arsenic inhibits pyruvate dehydrogenase by binding to the sulfhydryl groups of dihydrolipoamide. Trivalent arsenic inhibits numerous other cellular enzymes through sulfhydryl group binding. More importantly, pentavalent arsenic resembles inorganic phosphate and substitutes for phosphate in glycolytic and cellular respiration pathways. High-energy phosphate bonds are not made, and uncoupling of oxidative phosphorylation occurs. No pesticidal fatalities were reported in 1994.
Men are more likely to experience industrial arsenic exposure than women.
Arsenic exposure is usually suicidal, homicidal, or occupational. Record a careful work history on individuals with symptoms of a painful peripheral neuropathy to reveal the exposure. Determining unusual cases requires a careful history regarding dietary and nutritional habits, hobbies, and alcohol abuse. In trivalent arsenic poisoning, clinical effects depend on the chronicity of exposure. Chronic hepatic and renal damage is common with chronic exposure.