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Massive lindane overdose with toxicokinetics analysis.

D A Wiles1, J L Russell, K R Olson

  • 1Nationwide Children's Hospital Medical Toxicology Fellowship, The Ohio State University Wexner Medical Center, 700 Children's Drive (Bldg 255 RM-344), Columbus, OH, 43205, USA, devin.wiles@nationwidechildrens.org.

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
|May 9, 2014
PubMed
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This case study highlights a massive lindane ingestion where the patient survived the acute overdose. The prolonged terminal half-life of lindane suggests a risk of accumulation with repeated exposure.

Area of Science:

  • Toxicology
  • Pharmacokinetics
  • Environmental Health

Background:

  • Lindane, a pesticide, is a potential carcinogen with teratogenic, immunologic, and neurotoxic effects.
  • Despite environmental bans by the EPA, the FDA permits lindane as a second-line treatment for scabies and lice.
  • Lindane use is associated with severe adverse events, including seizures, coma, and death.

Observation:

  • A patient ingested a massive quantity of lindane in a suicide attempt.
  • The patient survived the acute ingestion event.
  • The patient expired from an unrelated cause before hospital discharge.

Findings:

  • Pharmacokinetic analysis revealed an unusually long terminal half-life for lindane (162.9 hours).
  • This extended half-life is significantly longer than previously reported values (25-36 hours).

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  • The prolonged half-life indicates a risk of lindane accumulation with repeated exposures.

    • Implications:

    • Massive lindane overdose can lead to delayed toxicity and prolonged recovery.
    • The extended half-life necessitates careful monitoring and consideration of potential accumulation.
    • This case underscores the risks associated with lindane use, even in a single massive ingestion scenario.