Pathophysiologic effects of As5+ (As5+; arsenate) Pathophysiologic effects of As5+ (As5+; arsenate). (A) Arsenate (chemical formula AsO43–) substitutes for inorganic phosphate (Pi; * indicates substitutions), bypassing the formation of 1,3-bisphosphoglycerate (1,3-BPG), and thus losing the ATP formation that occurs when 1,3-BPG is metabolized to 3-phosphoglycerate. (B) Energy loss also occurs if arsenate substitutes for Pi and blocks the formation of ATP from ADP. ADP = adenosine diphosphate; ATP = adenosine triphosphate. Source: Arsenic, Goldfrank's Toxicologic Emergencies, 10e Citation: Hoffman RS, Howland M, Lewin NA, Nelson LS, Goldfrank LR. Goldfrank's Toxicologic Emergencies, 10e; 2015 Available at: https://accesspharmacy.mhmedical.com/DownloadImage.aspx?image=/data/books/1163/gol_ch89_f002.png&sec=65099041&BookID=1163&ChapterSecID=65099014&imagename= Accessed: December 19, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved