Madhuri Pratti, Mukherjee Anirudh, Manna Sukdev, Dhar Minakshi
Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Family Med Prim Care. 2020 Apr 30;9(4):2129-2131. doi: 10.4103/jfmpc.jfmpc_1268_19. eCollection 2020 Apr.
Amitraz is a worldwide available pesticide of formamidine chemical family, proven to have reversible toxic effects on both animals and humans. Upon intoxication by ingestion, inhalation, or dermal route, it can cause various central nervous system (CNS), CVS, respiratory and gastrointestinal effects, some of which may be life threatening. Because of lack of specific antidote patients are usually managed with supportive and symptomatic management. We describe a case of 36-year-old female patient who presented to us with alleged history of 120 ml amitraz ingestion. She was given early gastric lavage with activated charcoal at emergency along with supportive and symptomatic management. She developed mild CNS depression, bradycardia, miosis, and fluctuating blood pressure. She was managed in intensive care unit and was kept under close hemodynamic monitoring. Her clinical course during hospital stay was uneventful and was successfully discharged without any residual deficits. According to previously published data, this amount of amitraz intoxication could have caused more serious clinical manifestations. This disproportionately less severe clinical manifestation in our patient is attributed to early gastric lavage. Ominous of reducing amitraz-related health hazards lies in the hands of primary health care physicians and regulatory bodies of government.
双甲脒是一种在全球范围内都可获得的甲脒类化学农药,已证实对动物和人类都有可逆的毒性作用。经口摄入、吸入或经皮肤途径中毒后,它可引起各种中枢神经系统(CNS)、心血管系统(CVS)、呼吸系统和胃肠道的影响,其中一些可能危及生命。由于缺乏特效解毒剂,患者通常采用支持性和对症治疗。我们描述了一例36岁女性患者,据称有摄入120毫升双甲脒的病史。在急诊时,她接受了早期洗胃并给予活性炭,同时进行支持性和对症治疗。她出现了轻度中枢神经系统抑制、心动过缓、瞳孔缩小和血压波动。她在重症监护病房接受治疗,并进行密切的血流动力学监测。她住院期间的临床过程平稳,顺利出院,没有任何遗留缺陷。根据先前发表的数据,这种剂量的双甲脒中毒本可能导致更严重的临床表现。我们患者中这种不成比例的较轻临床表现归因于早期洗胃。减少双甲脒相关健康危害的关键在于初级卫生保健医生和政府监管机构。