Shilpakar Olita, Karki Bipin
Department of General Practice and Emergency Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
Department of Critical Care Medicine, Om Hospital and Research Centre, Kathmandu, Nepal.
Toxicol Rep. 2020 Dec 10;8:10-12. doi: 10.1016/j.toxrep.2020.12.005. eCollection 2021.
Pyrethrins and their synthetic derivatives known as pyrethroids are highly effective insecticides used worldwide in the agricultural fields and households. Cypermethrin is a type II pyrethroid which acts primarily by delaying the closure of voltage-sensitive sodium channels at higher concentrations. Its toxicity in humans occur due to accidental or intentional exposure through inhalation, skin contact or via ingestion. Acute oral intoxication of cypermethrin commonly manifests with neurotoxic and gastrointestinal effects in humans. Cardiotoxic effects following ingestion of this compound have occurred in a few cases but underreported to date. This case highlights a case of intentional cypermethrin poisoning with acute effects in the form of prolonged bradycardia symptomatically managed with a muscarinic antagonist like atropine sulphate.
除虫菊酯及其合成衍生物拟除虫菊酯是全球农业领域和家庭中广泛使用的高效杀虫剂。氯氰菊酯是一种II型拟除虫菊酯，主要作用是在较高浓度下延迟电压敏感性钠通道的关闭。人类接触氯氰菊酯会因意外或故意吸入、皮肤接触或摄入而中毒。氯氰菊酯急性口服中毒在人类中通常表现为神经毒性和胃肠道反应。少数情况下摄入该化合物后会出现心脏毒性作用，但迄今为止报告不足。本病例突出了一例故意氯氰菊酯中毒事件，其急性效应表现为长时间心动过缓，通过使用硫酸阿托品等毒蕈碱拮抗剂进行对症治疗。
