MMH ED Poison Center: Abamectin / emamectin/ Ivermectin Intoxication

2023年8月19日星期六

Abamectin / emamectin/ Ivermectin Intoxication

Year	Country	Substance / Dose	Treatment / Outcome	Reference
2003	Taiwan	Oral application of ABM (20 mg/kg)	Concomitant epinephrine injection [100 micro-gm/ kg, subcutaneously (s.c.).	1
1999	Taiwan	Eighteen patients with abamectin (Agri-Mek; 2% wt/wt abamectin) exposure and 1 with ivermectin (Ivomec; 1% wt/vol ivermectin) ingestion.	Male: Female =14: 5 37% coma 37% admit to ICU 21% asymptomatic 16% hypotension 5% die of MOF.	2
2022	Taiwan	60 had ingested emamectin pesticides, and 4 had ingested abamectin.	Drowsiness (47%) Shortness of breath (SOB)/dyspnea (33%) Nausea/vomiting (22%). (27%) were intubated. (31%) had severe outcomes. (78%) were admitted 42% required intensive care unit (ICU). 6.3% died GCS score < 13 (OR 68.1, 95% CI 3.8-999) and the presence of SOB/dyspnea (OR 50.2, 95% CI 3.0-849.9) were associated with severe outcomes.	3
2015	People's Republic of China	Ingestion of a large dose of abamectin on purpose	Rapidly recovered consciousness after administration of flumazenil.	4
2004	Taiwan	Proclaim insecticide (Syngenta, Taiwan), consisting of 2.15% w/w emamectin benzoate in 2, 6-bis (1, 1-dimethylethyl)-4-methyl-phenol and 1-hexanol.	Transient gastrointestinal upset with endoscopy-proven gastric erosion and superficial gastritis, mild central nervous system depression, and aspiration pneumonia. Treated successfully with gastric lavage, administration of activated charcoal, and empiric antibiotics.	5
2007	Turkey	Toxic effects of abamectin are usually seen after abamectin oral ingestions.	Altered mental status, respiratory failure, and hypotension.	6
2016	China	acute avermectins poisoning	Nystagmus is rarely reported	7
2014	Iran	3600 mg abamectin orally.	Gastric lavage charcoal was administered. Altered mental status drowsiness, hypotension, tachycardia and dermal erythema. Treated as H1 and H2 blockers and vasoactive agents Altered mental status could be considered as the first sign of abamectin intoxication. Conservative treatment is recommended.	8
2020	People's Republic of China	400 mL of 5% abamectin pesticide.	Serious brain dysfunction and abnormal EEG caused by abamectin poisoning are treatable. Despite poor clinical and EEG findings at the outset, recovery is still possible.	9