Substance
Glufosinate-Ammonium 13.5%SL
Common name / Trade name
強手(固殺草);
Involving system
-
Mechanism: glutamine
synthetase-inhibiting [1]
-
Interferes with glutamate
synthetase activity [2]
-
Neurotoxicity.
-
Mental disturbances [3]
-
Hematological changes
-
Gastrointestinal effects [3], nausea.
Presentation
-
Altered mental status [4] amnesia [2]
-
Fever [2]
-
Arrhythmia, [2]
-
Seizure, 31.5% [5]
-
higher initial ammonia levels. [6]
-
respiratory failure. [7]
-
Vasogenic edema in striatum [8]
-
Shock
[2]
Antidote and Treatment
-
Activated charcoal, Carbomix [2].
-
IVF, monitoring urine output.
-
Intubation if respiratory
failure
-
Monitoring.
-
supportive care.
-
benzodiazepine for seizure
-
Without antidote.
-
Hemodialysis [2]
Disposition
-
Observe 48 hours, [2]
-
Age > 70 years and GCS score
< 9 at triage could be predictors of mortality in patients. [4]
-
An initial serum ammonia level
>151 µg/dL was an independent early predictor of in-hospital mortality [9]
-
Older age (≥ 61 years; adjusted
OR 4.9) and larger amount of glufosinate ingestion (≥ 13.9 grams; adjusted OR
25.2) were positively associated with the development of severe toxicity [10].
-
6.1% to 17.7% died following
deliberate glufosinate ingestion. [2, 10]
References
[1]. https://pubmed.ncbi.nlm.nih.gov/36963955/
[2].Goldfrank’s Toxicology Emergencies
p1478—79. 11th ed.
[3] https://pubmed.ncbi.nlm.nih.gov/9491336/
[4] https://pubmed.ncbi.nlm.nih.gov/34392143/
[5]. https://pubmed.ncbi.nlm.nih.gov/28421825/
[6] https://pubmed.ncbi.nlm.nih.gov/36399183/
[7]. https://pubmed.ncbi.nlm.nih.gov/24044532/
[8] https://pubmed.ncbi.nlm.nih.gov/19581091/
[9]. https://pubmed.ncbi.nlm.nih.gov/31146590/
[10] https://pubmed.ncbi.nlm.nih.gov/22480254/
Edited by Yu-Jang Su May 1st, 2023.