Treatment of Aluminium Phosphide Poisoning with a Combination of Intravenous Glucagon, Digoxin and Antioxidant Agents
Journal Title: Sultan Qaboos University Medical Journal - Year 2016, Vol 16, Issue 3
Abstract
Aluminium phosphide (AlP) is used to protect stored grains from rodents. It produces phosphine gas (PH3), a mitochondrial poison thought to cause toxicity by blocking the cytochrome c oxidase enzyme and inhibiting oxidative phosphorylation, which results in cell death. AlP poisoning has a high mortality rate among humans due to the rapid onset of cardiogenic shock and metabolic acidosis, despite aggressive treatment. We report a 21-yearold male who was referred to the Afzalipour Hospital, Kerman, Iran, in 2015 after having intentionally ingested a 3 g AlP tablet. He was successfully treated with crystalloid fluids, vasopressors, sodium bicarbonate, digoxin, glucagon and antioxidant agents and was discharged from the hospital six days after admission in good clinical condition. For the treatment of AlP poisoning, the combination of glucagon and digoxin with antioxidant agents should be considered. However, evaluation of further cases is necessary to optimise treatment protocols.
Authors and Affiliations
Zohreh Oghabian| Department of Medical Toxicology, Kerman University of Medical Sciences, Kerman, Iran, Omid Mehrpour| Atherosclerosis & Coronary Artery Research Centre and Medical Toxicology & Drug Abuse Research Centre, Birjand University of Medical Sciences, Birjand, Iran
Acute Coronary Syndrome, Diabetes and Hypertension Oman must pay more attention to chronic non-communicable diseases
Heerfordt’s Syndrome An interesting and under-recognised manifestation of sarcoidosis
Silent Epidemic of Depression in Women in the Middle East and North Africa Region Emerging tribulation or fallacy?
As the world is being gripped by economic depression, international psychological epidemiologists have amassed evidence to suggest that psychological depression and its variants are becoming leading contributors to the...
Subclinical Sickle Cell Crisis during Cardiopulmonary Bypass Timely detection and early management
A sickle cell crisis can occur during cardiopulmonary bypass for cardiac surgical procedures in patients with sickle cell hemoglobin, which could lead to hemolysis. Tere is a dearth of such reports from the Arab world....
Multi-Factorial Causes of Torsade De Pointes in a Hospitalised Surgical Patient
A 55-year-old chronic alcoholic male known to be positive for human immunodefciency virus (HIV) was admitted to a surgical ward following perianal abscess drainage. He was noted to have sinus bradycardia, ventricular p...