Acute aluminum phosphide poisoning: evolving perspectives on toxic mechanisms and evidence-based clinical management

Aluminium phosphide (AlP) is a chemical compound that is used as a pesticide for suicidal purposes and can cause death, and it poses a challenge to health in some countries. AlP in the presence of stomach acid leads to the release of phosphine, which inhibits mitochondrial function and reduces ATP levels. This poisoning has devastating effects on the front line of damage on the cardiovascular and gastrointestinal systems, causing symptoms such as vomiting, cardiac arrhythmias, and heart failure.A focused search was performed utilising the terms 'aluminium phosphide,' 'phosphine,' 'antidote,' 'case report,' and 'treatment' within the scientific databases Scopus, Web of Science, and PubMed. Studies have shown that supportive treatment, decontamination, and antioxidant therapy can help reduce toxic effects.Many studies have been conducted in vitro and in clinical models to identify specific antidotes, providing valuable insight into the management of poisoning. Given the lack of a particular antidote, new therapeutic approaches offer promising solutions for managing this poisoning.New knowledge, including artificial intelligence, can help prevent and manage diseases and treatments. However, further efforts are needed to develop more effective treatments and prevent the misuse of this substance.