Salyrgan

SALYRGAN, Salyrganum, a complex mercury compound of sodium salicylallylamido-oxyacetate; contains 36% mercury in non-ionized form. Formula (according to Girard): OH . Hg . CH₂ . CH(OCH₃) . CH₂ . NH . CO . C₆H₄O . CH-CO₂Na; structural formula /OCH₂COONa °j^3H2 ^CeH4\CONH-CH₂-CH-----CH, I Hg.00C.CH₃ A white, almost odorless, finely crystalline powder; soluble in 1 part of water and 3 parts of alcohol, insoluble in ether; solutions are of alkaline reaction and stable. It is well absorbed, excreted mainly through the kidneys and intestines. It does not possess a local action, unlike many mercury compounds, because it does not coagulate protein; it causes neither pain nor infiltration upon parenteral administration. Upon resorptive action, it causes a strong diuresis in the first hours after administration. Diuresis is caused not only by renal factors: increased filtration through the endothelium of Malpighian glomeruli and the epithelium of Bowman's capsules due to the irritating action of mercury ions, decreased reabsorption of chlorides and water in the tubules; of importance is also the change in the water equilibrium of tissues (extrarenal factors of diuresis): dehydration of tissues, extraction of water and chlorides from them. Ultimately, an increased diuresis with a high percentage of chlorides in the urine is obtained. The amount of chlorides can increase 5-12 times, and water by 50-60%. In terms of diuretic effect, Salyrgan is somewhat inferior to novasurol, equal to neptal (see Mercury), but the toxicity of Salyrgan is ¹/₆ less than the toxicity of the former. The lethal dose upon intravenous administration is approximately 0.029-0.03 per 1 kg of animal weight; the toxic dose (experiments on rats), calculated for mercury, is 1.2 mg. Side effects from therapeutic doses of Salyrgan are not noted; sometimes only diarrhea occurs.

The main indications are cardiac edema with sufficient kidney function in patients with heart defects; the effect is somewhat weaker in diseases of the heart muscle, even weaker in ascites from cirrhosis or syphilis of the liver, in edema due to pleurisy, peritonitis, tuberculosis, in polyserositis; but even in these cases, diuresis can reach up to 4 liters per day. The action of Salyrgan is enhanced by theophylline and ammonium chloride by 3-4 times. Dose: 0.5-2 cm³ of a 10% solution into a vein, muscle, or under the skin. Another indication is syphilis. Salyrgan is used perse or more often together with novosalvarsan, 0.5-2 cm³ of a 10% solution into a muscle or vein 3 times a week or every 2 days; a total of 5-9 injections. In view of partial excretion through the biliary tract and its bactericidal action, Salyrgan is recommended for the treatment of typhoid bacillus carriers. Salyrgan is contraindicated in obvious symptoms of nephritis. Salyrgan is produced by foreign firms in 1% and 10% solutions in 1 cm³ ampoules; the 10% solution is used for syphilis (1 gram of it corresponds to approximately 0.03 mercury).