Phosphorus

(BAN)

💊 Chemical information

Fósforo; Fósforo amarillo; Fósforo blanco; Phosphor; Phosphore; White Phosphorus; Yellow Phosphorus.
P = 30.973762.
CAS — 7723-14-0.

Handling.

Phosphorus has been used for the illicit preparation of explosives or fireworks; care is required with its supply.

Stability and storage.

Phosphorus is unstable in air and should be stored under water.

💊 Adverse Effects

Acute poisoning by yellow (white) phosphorus, a general protoplasmic poison, occurs in three distinct stages. The first stage represents local gastrointestinal irritation with intense thirst, pain, nausea, vomiting, and diarrhoea. The vomitus and stool may smell of garlic and are luminescent. Shock, delirium, convulsions, coma, and death may occur. In patients who survive, a second, asymptomatic stage may be present lasting for up to several days or even weeks. The third stage represents systemic toxicity characterised by hepatic and renal damage, cardiovascular collapse, and CNS involvement including confusion, convulsions, and coma. Death may occur during either the first or third stages. The fatal dose is about 1 mg/kg. Symptoms of chronic poisoning are associated with defective tissue repair, including necrosis of the mandible (‘phossy jaw’). Externally, phosphorus causes severe burns to the skin. Phosphorus is absorbed after skin contamination and systemic symptoms may occur.

💊 Treatment of Adverse Effects

Gastric lavage may be considered after ingestion of elemental yellow (white) phosphorus, although the risks versus potential benefits must be considered in order to prevent spontaneous combustion. Activated charcoal may be used, although there is no clear evidence of benefit. Induction of emesis is contra-indicated. Potassium permanganate solution 1 in 5000 has been instilled into the stomach in an attempt to convert elemental phosphorus to an oxide, but there is no sound clinical reason to recommend this. Further treatment is symptomatic and supportive and may include fluid and electrolyte replacement, and management of convulsions and renal and hepatic dysfunctions. Contaminated areas on skin should be immersed in water or irrigated with copious amounts of warm water. Solutions containing copper sulfate have also been suggested for dermal irrigation to convert elemental phosphorus to copper phosphate, although concerns have been raised due to its potential to cause lethal haemolysis through inhibition of G6PD. Eyes contaminated with phosphorus should be irrigated with copious amounts of tepid water for at least 15 minutes. Exposed areas should be covered with wet dressings or compresses to prevent spontaneous combustion. It is essential that all particles of unoxidised phosphorus are removed from the skin. Lipid or oil-based topical preparations may increase the absorption of phosphorus through the skin and should not be used.

💊 Uses and Administration

Elemental phosphorus is no longer used in medicine. Inorganic phosphates are given in deficiency states and bone diseases. Phosphorus has been used in the manufacture of rat and cockroach poisons.

Homoeopathy.

Phosphorus has been used in homoeopathic medicines.

💊 Preparations

Proprietary Preparations

Multi-ingredient: Arg.: Sigmaflex; Singapore: Lacto Calcium†.
Published May 08, 2019.