Paraquat poisoning

 

Substance

-  Paraquat.

Common name or Trade name

-   巴拉刈. 速草淨, 全草滅, 草蕪松 [1]

Involving system

-      Gastrointestinal – oral, transient liver toxicity, jaundice. [1]

- lung: pulmonary fibrosis [1]

- kidney: ATN, AKI [1]

- heart: hypotension, myocarditis, arrhythmia. [1]

- AMS- mental change. Seizure. Coma. [1]

Presentation 

-       Nausea, vomiting. [1]

-       Diarrhea [1]

-       Dyspnea [1]

-       Pneumoperitoneum, pneumomediastinum [2].

-       Seizure [1]

-       jaundice [1]

-       Coma [1]

-       Asystole. [1]

Antidote and Treatment

-       Decontamination: remove clothes, washing [1].

-       NG irrigation within 1 hour [1].

-       Fuller earth, 100—150 gm. Child: 2 gm/kg BW. Activated charcoal 25—100gm, child 25—50 gm [1].

-       Hemoperfusion within 2—4 hours [1].

-       Hemodialysis if renal failure [1].

-       No antidote.

Disposition 

-       MICU in confirmed poisoning cases with hemodynamic unstable.

-       25% to 44% of mortality rate in pregnant women [3].

REFERENCES

1.      急診醫學會AILS三版P.85—94.

 

2.      James N, Bakshi R, Rudresh SS, Kaushik K, Ghumaan KS, Pannu AK. Pneumoperitoneum from pneumomediastinum in paraquat poisoning. Trop Doct. 2020 Sep 30:49475520960872. doi: 10.1177/0049475520960872. Epub ahead of print. PMID: 32998627.

 

3.      Trakulsrichai S, Paisanrodjanarat B, Sriapha C, Tongpoo A, Udomsubpayakul U, Wananukul W. Clinical outcome of paraquat poisoning during pregnancy. Clin Toxicol (Phila). 2019 Aug;57(8):712-717. doi: 10.1080/15563650.2018.1549328. Epub 2019 Jan 28. PMID: 30689470.

edited by Yu-Jang Su  Feb 27, 2021.