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Acute phenthoate self-poisoning: a prospective case series
Lekaashree Rambabu1,2, Fahim Mohamed3,4, Jeevan Dhanarisi3
1National Health Service Tayside, Dundee, UK.
Clinical Toxicology (Philadelphia, Pa.)
|May 7, 2021
Summary
Organophosphorus insecticide phenthoate self-poisoning resulted in a 6.5% case fatality rate, with most deaths occurring in intubated patients. Pralidoxime showed a temporary increase in cholinesterase activity for phenthoate poisoning.
Area of Science:
- Toxicology
- Clinical Medicine
- Public Health
Background:
- Organophosphorus (OP) insecticide poisoning characteristics vary by agent.
- Phenthoate, a WHO Hazard Class II OP pesticide, has limited documented clinical data.
- Understanding phenthoate's clinical profile is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of phenthoate self-poisoning.
- To identify factors associated with mortality in phenthoate poisoning cases.
- To evaluate the initial response to oxime therapy in phenthoate poisoning.
Main Methods:
- Prospective cohort study of 292 patients with phenthoate self-poisoning in Sri Lanka (2002-2018).
- Clinical outcomes, including intubation rates and mortality, were recorded.
- Plasma phenthoate concentrations and cholinesterase activity were measured in a subset of patients.
Main Results:
- A case fatality rate of 6.5% was observed.
- Respiratory failure necessitating intubation occurred in 14.4% of patients, with most deaths in those intubated within 24 hours.
- A transient increase in cholinesterase activity was noted with pralidoxime administration.
Conclusions:
- Phenthoate self-poisoning presents a significant mortality risk.
- Early intubation is common for respiratory failure, but most deaths occurred in this subgroup.
- The efficacy of oximes like pralidoxime in phenthoate poisoning requires further investigation.
Keywords:
Phenthoateorganophosphate toxicityorganophosphorus compoundspesticide poisoningphenthoate poisoningMore Related Videos
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