Karimani Asieh, Mohammadpour Amir Hooshang, Zirak Mohammad Reza, Rezaee Ramin, Megarbane Bruno, Tsatsakis Aristidis, Karimi Gholamreza
Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Toxicol Rep. 2018 Oct 28;5:1053-1059. doi: 10.1016/j.toxrep.2018.10.009. eCollection 2018.
Aluminum phosphide (AlP), an inexpensive solid fumigant, is frequently used for grain conservation despite its alleged high toxicity. Increased utilization of AlP for agricultural and non-agricultural purposes during the last four decades has resulted in increment of AlP-attributed poisoning numbers. Moreover, due to its limitless accessibility in developing countries, AlP has been increasingly used for suicide. Moisture-exposed AlP undergoes a chemical reaction producing phosphine gas, which in turn inhibits cytochrome oxidase and impedes cellular oxygen consumption. Lethality remains elevated reaching rates of >50% and no effective antidote is available. Nevertheless, experimental and clinical studies suggested that magnesium sulfate, melatonin, -acetylcysteine, glutathione, sodium selenite, vitamin C and E, triiodothyronine, liothyronine, vasopressin, milrinone, L., 6-aminonicotinamide, boric acid, acetyl-L-carnitine and coconut oil, may serve as antidotes by reducing the deleterious oxidative properties of AlP. This article reviews the afore-mentioned chemicals suggested to specifically treat AlP poisoning and discusses their protective mechanisms and main outcomes.
磷化铝（AlP）是一种价格低廉的固体熏蒸剂，尽管据称其毒性很高，但仍经常用于粮食保存。在过去四十年中，磷化铝在农业和非农业用途上的使用增加，导致磷化铝中毒人数上升。此外，由于在发展中国家其获取途径不受限制，磷化铝越来越多地被用于自杀。暴露于湿气中的磷化铝会发生化学反应产生磷化氢气体，进而抑制细胞色素氧化酶并阻碍细胞耗氧。致死率仍然很高，超过50%，且没有有效的解毒剂。然而，实验和临床研究表明，硫酸镁、褪黑素、N-乙酰半胱氨酸、谷胱甘肽、亚硒酸钠、维生素C和E、三碘甲状腺原氨酸、碘塞罗宁、血管加压素、米力农、L、6-氨基烟酰胺、硼酸、乙酰-L-肉碱和椰子油，可能通过降低磷化铝的有害氧化特性而起到解毒作用。本文综述了上述建议用于特异性治疗磷化铝中毒的化学物质，并讨论了它们的保护机制和主要结果。
