Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/200401
Type: Artigo de periódico
Title: Poisoning By Illegal Rodenticides Containing Acetylcholinesterase Inhibitors (chumbinho): A Prospective Case Series.
Author: Bucaretchi, Fábio
Prado, Camila C
Branco, Maíra M
Soubhia, Paula
Metta, Gisele M
Mello, Sueli Moreira
de Capitani, Eduardo Mello
Lanaro, Rafael
Hyslop, Stephen
Costa, Jose Luiz
Fernandes, Luciane C R
Vieira, Ronan José
Abstract: To describe a prospective case series of poisonings caused by ingestion of illegal rodenticides containing acetylcholinesterase inhibitors, mainly chumbinho, followed-up by the Campinas PCC for a period of 1 year. Seventy-six cases were included, of which 53.9% were males. Age ranged from 2 to 74 years (median = 36 years). The main circumstances leading to poisoning were intentional (suicide attempts 92.1%; homicide attempts 5.3%), and 65.8% were admitted less than 2 hours after ingestion. Most of the patients (96.1%) showed cholinergic muscarinic manifestations, particularly salivation (86.8%), myosis (77.6%), sweating (50%), and bronchorrhea (35.5%). Atropine was used in 82.9% of patients (median = 2 days), intubation and mechanical ventilation in 46.1% (median = 3 days), and the median length of the hospital stay was 4 days. Plasma samples obtained upon admission in 59 cases revealed (LC-MS/MS): aldicarb (55), carbofuran (2), aldicarb and carbofuran (1), no active component (1). In most of the plasma and urine samples collected upon admission, the highest concentrations (ng/mL) obtained were for the active metabolite aldicarb sulphoxide (plasma, median = 831, IIQ = 99.2-2885; urine, median = 9800, IIQ = 2000-15000) than aldicarb (plasma, median = 237, IIQ = 35.7-851; urine, median = 584, IIQ = 166-1230), indicating rapid metabolism. The excretion of aldicarb and its metabolites was rapid since these compounds were rarely detected in plasma samples 48 hours after admission. Sequential cholinesterase analysis in 14 patients revealed almost complete reactivation in the first 48 hours post-admission, compatible for poisoning by carbamates. Based on the Poisoning Severity Score, the cases were classified as asymptomatic (5.3%), minor (11.8%), moderate (35.5%), severe (43.4%), and fatal (3.9%). Most poisonings involved aldicarb and resulted from suicide attempts; the poisonings were generally severe, with a mortality of 3.9%. Aldicarb was rapidly absorbed, metabolized, and excreted.
Subject: Adolescent
Adult
Aged
Aldicarb
Angiotensin-converting Enzyme Inhibitors
Atropine
Carbofuran
Child
Child, Preschool
Female
Humans
Infant
Male
Middle Aged
Muscarinic Antagonists
Rodenticides
Suicide, Attempted
Young Adult
Citation: Clinical Toxicology (philadelphia, Pa.). v. 50, n. 1, p. 44-51, 2012-Jan.
Rights: fechado
Identifier DOI: 10.3109/15563650.2011.639715
Address: http://www.ncbi.nlm.nih.gov/pubmed/22175788
Date Issue: 2012
Appears in Collections:Unicamp - Artigos e Outros Documentos

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