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Review article

https://doi.org/10.2478/10004-1254-63-2012-2182

A Systematic Review of Aluminium Phosphide Poisoning

Omid Mehrpour ; Department of Clinical Toxicology, Tehran University of Medical Sciences, Tehran, Iran
Mostafa Jafarzadeh ; Birjand University of Medical Sciences (BUMS), Birjand, Department of Forensic Medicine and Toxicology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Abdollahi ; Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran


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Abstract

Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine gas as the tablet gets into contact with moisture. Phosphine gas primarily affects the heart, lungs, gastrointestinal tract, and kidneys. Poisoning signs and symptoms include nausea, vomiting, restlessness, abdominal pain, palpitation, refractory shock, cardiac arrhythmias, pulmonary oedema, dyspnoea, cyanosis, and sensory alterations. Diagnosis is based on clinical suspicion, positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination with coconut oil and sodium bicarbonate, administration of charcoal, and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Moreover, acidosis can be treated with early intravenous administration of sodium bicarbonate, cardiogenic shock with fluid, vasopresor, and refractory cardiogenic shock with intra-aortic baloon pump or digoxin. Trimetazidine may also have a useful role in the treatment, because it can stop ventricular ectopic beats and bigeminy and preserve oxidative metabolism. This article reviews the epidemiological, toxicological, and clinical/pathological aspects of AlP poisoning and its management.

Keywords

human poisoning; mechanism of toxicity; phosphine; phosphides; pesticides

Hrčak ID:

78648

URI

https://hrcak.srce.hr/78648

Publication date:

21.3.2012.

Article data in other languages: croatian

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