Wilson William, Murty Shakuntala
Department of Emergency Medicine, St. John's Medical College, Bengaluru, Karnataka, India.
J Emerg Trauma Shock. 2018 Apr-Jun;11(2):140-142. doi: 10.4103/JETS.JETS_33_17.
Pesticide poisoning is always a clinical conundrum for the emergency physician (EP), the complexity of which increases when the pesticide has no antidote! Over the past decade, there has been a sharp increase in cases of Amitraz poisoning, a pesticide routinely used in veterinary medicine, available without a prescription. The usual presentation includes bradycardia, hypotension, poor sensorium, and miosis. In the absence of accurate history, these clinical features can be confused with the cholinergic toxidrome of organophosphorus poisoning. There is a dearth of literature regarding the presentation and protocols for the management of Amitraz poisoning with data mostly based on animal studies and pediatric case reports. Currently, the available medical literature in the form of case reports and case series form an invaluable source of information to the EP to formulate a working diagnosis and methodical approach to this pesticide. Here, we present two case reports highlighting the characteristic clinical features and bringing to light how an organized approach to the toxin can give satisfactory results.
农药中毒一直是急诊医生面临的临床难题，当某种农药没有解毒剂时，其复杂性就会增加！在过去十年中，双甲脒中毒病例急剧增加，双甲脒是一种常用于兽医学的非处方药。常见症状包括心动过缓、低血压、意识不清和瞳孔缩小。在缺乏准确病史的情况下，这些临床特征可能会与有机磷中毒的胆碱能中毒综合征相混淆。关于双甲脒中毒的临床表现和治疗方案的文献匮乏，现有数据大多基于动物研究和儿科病例报告。目前，以病例报告和病例系列形式呈现的医学文献是急诊医生制定该农药的初步诊断和系统治疗方法的宝贵信息来源。在此，我们展示两例病例报告，突出其特征性临床特征，并揭示对该毒素采取有条理的治疗方法如何能取得满意效果。
