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Human parathion poisoning. A toxicokinetic analysis
Florian Eyer1, Veronika Meischner, Daniela Kiderlen
1Toxicological Department of II. Medical Clinic, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
Toxicological Reviews
|June 9, 2004
Summary
Parathion poisoning shows high mortality. Patient outcomes vary due to differences in absorbed poison and its active form, paraoxon, influencing toxicokinetics and treatment effectiveness.
Area of Science:
- Toxicology
- Pharmacokinetics
- Clinical Medicine
Background:
- Suicidal parathion poisoning presents with severe cholinergic symptoms and high mortality.
- Clinical outcomes vary significantly despite uniform initial presentation and treatment protocols.
Observation:
- This study investigated the toxicokinetics of parathion and its active metabolite, paraoxon, in severely intoxicated patients.
- Key parameters monitored included plasma parathion and paraoxon levels, erythrocyte acetylcholinesterase activity, obidoxime concentration, and urinary para-nitrophenol conjugate excretion.
- Absorption of parathion was sometimes delayed up to 5 days, leading to fluctuating plasma levels and significant distribution into fat tissue.
Findings:
- The amount of parathion absorbed varied widely and was often lower than reported.
- Biotransformation of parathion was highly variable and could be affected by other medications like fluconazole.
- Obidoxime efficacy was observed at low paraoxon concentrations, but this correlated poorly with overall poison load.
Implications:
- Understanding individual toxicokinetic variations is crucial for managing parathion poisoning.
- Accurate quantification of poison load and metabolite levels can guide treatment strategies.
- Further research into factors affecting parathion metabolism and distribution is warranted for improved patient outcomes.