Shitole D G, Kulkarni R S, Sathe S S, Rahate P R
C.P.R. Hospital and R.C.S.M.Govt. Medical College, Kolhapur.
J Assoc Physicians India. 2010 May;58:317-9.
To report the clinical features, laboratory findings and the management instituted for the patients with acute Amitraz Poisoning.
Three cases of acute Amitraz Intoxication were studied and compared with previous reports from the literature.
All the three female cases were brought to our hospital with age ranging from 2 years to 40 years, consumed poison by oral route. The ingested amount was ranging from 15 ml to 30 ml. Giddiness and vomiting were the prominent symptoms, next were drowsiness, irritability and respiratory distress. Two cases revealed gastric dilatation. Except hyperglycaemia and glucosuria other laboratory parameters were normal. Unconscious patient's CT brain revealed brain edema. One patient with hypotension improvement with i.v. fluids administration. All the patients recovered completely.
Formamidines show toxic effects on both humans and animals. Amitraz is slightly toxic. Amitraz shows hepatotoxic, CNS stimulative or depressive effects. It can cause gastric stasis. Amitraz leads to rise in plasma glucose level and suppress insulin release. Decreased body temperature is due to inhibitory effect of Amitraz on Prostaglandin E2 synthesis. Even after poisoning by potentially lethal dose of Amitraz, studies have reported complete recovery. As there is no specific antidote for Amitraz Poisoning the medical management with O2 supplementation, airway maintenance, proper hydration and supportive management are the key factors for complete recovery of the patient. Public Health Education and instructions to drug producing companies will be necessary to decrease the incidence of Amitraz Poisoning.
报告急性双甲脒中毒患者的临床特征、实验室检查结果及所采取的治疗措施。
对3例急性双甲脒中毒病例进行研究，并与文献中先前的报道进行比较。
所有3例女性患者年龄在2岁至40岁之间，均经口服摄入毒物后被送至我院。摄入量为15毫升至30毫升。头晕和呕吐是主要症状，其次是嗜睡、易怒和呼吸窘迫。2例出现胃扩张。除高血糖和糖尿外，其他实验室指标均正常。昏迷患者的脑部CT显示脑水肿。1例低血压患者经静脉补液后病情改善。所有患者均完全康复。
甲脒类化合物对人和动物均显示出毒性作用。双甲脒毒性较小。双甲脒具有肝毒性、对中枢神经系统有刺激或抑制作用。它可导致胃潴留。双甲脒导致血浆葡萄糖水平升高并抑制胰岛素释放。体温降低是由于双甲脒对前列腺素E2合成的抑制作用。即使经潜在致死剂量的双甲脒中毒后，研究报告患者仍可完全康复。由于双甲脒中毒没有特效解毒剂，补充氧气、维持气道通畅、适当补液及支持治疗是患者完全康复的关键因素。开展公众健康教育并向药品生产公司发出指示对于降低双甲脒中毒的发生率是必要的。
