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metal foundaries, glass production & semiconductor industries), rodenticide, from contaminated wine, or because of malicious intent (remember the Borgias) Mechanism of Action: Inorganic forms of arsenic are more toxic than organic forms Very few organ systems escape the toxic effects of arsenic Trivalent inorganic arsenic inhibits pyruvate dehydrogenase (via binding to sulfhydryl groups), resulting in decreased citric acid cycle activity, and decreased production of cellular ATP Trivalent arsenic inhibits numerous other cellular enzymes through sulfhydryl group binding Trivalent arsenic inhibits cellular glucose uptake, gluconeogenesis, fatty acid oxidation, and further production of acetyl CoA