ALUMINUM PHOSPHIDE POISONING - CASE STUDY

Author's Name: Ali Th. Khlaif
Subject Area: Health Science
Subject Pharmacology and Toxicology
Section Case Studies

Keyword:

Aluminum phosphide, phosphine, sodium bicarbonate, arrhythmias, magnesium sulfate.


Abstract

Aluminum phosphide (AlP) is a cheap, effective and commonly used pesticide. It is one of the fatal pesticides. It liberates lethal phosphine gas when it comes in contact either with atmospheric moisture or with hydrochloric acid in the stomach. The mechanism of toxicity includes cellular hypoxia due to the effect on mitochondria, inhibition of cytochrome C oxidase and formation of highly reactive hydroxyl radicals. The signs and symptoms are nonspecific and instantaneous. The toxicity of AlP particularly affects the cardiac and vascular tissues, which manifest as profound and refractory hypotension, congestive heart failure and electrocardiographic abnormalities. The diagnosis of AlP usually depends on clinical suspicion or history, but can be made easily by the simple silver nitrate test on gastric content or on breath. Due to no known specific antidote, management remains primarily supportive care. Early arrival, resuscitation, diagnosis, decrease the exposure of poison ( by gastric lavage with KMnO4 or sodium bicarbonate ), intensive monitoring and supportive therapy may result in good outcome.

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