Substance
Thallium salts

Pathology
Combination with mitochondrial sulfhydryl groups, interference with oxidative phosphorylation.

Symptoms
Nausea, vomiting, abdominal pain, hematemesis, bloody diarrhea, headache, alopecia, hematuria, proteinuria, elevated hepatic enzymes, lethargy, tremors, ataxia, delirium, seizures, coma, death.

Emergency Measures
Activated charcoal; fluids and electrolytes intravenously; benzodiazepines for seizures. Hemoperfusion and hemodialysis may be moderately successful.

Comments
Alopecia and Mee's sign, single white transverse lines on the nails 2–3 weeks postexposure, are common diagnostic features. Long-term neurological impairment can occur.