SUBSTANCE
imidacloprid
poisoning
Common
name / Trade name
-
One kind of Neonicotinoid
-益達胺; 霹靂掌; 金剛棒; 一帖靈; 勁厲害
-First-generation
compounds appear to have significantly worse toxicity than second generation
compounds despite both being classified as class II compounds (moderately
hazardous) according to the WHO classification [1]
-Most were exposed
by ingestion (93.3%) [2]
Involving
SYSTEM
-Nervous system:
nausea or vomiting with nervous system involvement [1] neurological effects (14.2%) [2]
- competitive
inhibitor at the nicotinic acetylcholine receptors interfering with
the transmission of impulses leading to fatigue and paralysis. [3]
-Renal: rhabdomyolysis
resulting in acute kidney injury [4]
-GI: gastrointestinal symptoms (63.8%)
with no corrosive injuries [2]
- other: ischemic
and metabolic encephalopathy, multiorgan failure [4]
- arrhythmia:
ventricular fibrillation [4]
-
neuropsychiatric sequelae [4]
Presentation
-
altered consciousness (32.1%) or
muscle weakness (21.4%) [1]
-
drowsy but arousable, dyspnoeic, and
profusely sweating [3]
-
Autonomic nervous system: stimulation
causes sweating, dilated pupils, tachycardia, and hypertension [3]
-
nausea or vomiting, abdominal pain,
drowsiness, headache, or dizziness, but some cases may be asymptomatic [4]
-
Antidote
/ Treatment
-
GI decontamination. [3]
-
activated charcoal [4]
-
Intubation if unconscious [3]
-
No antidote, supportive care.
Disposition
-
predominantly male (60.7%) [1] no (18.4%) to mild (76.1%) toxicity [2]
-
A minority of patients required
invasive care (28.6%) or invasive ventilation (25.0%) [1]
-
ICU care: in high lactate, RR>
24.7/min, GCS<11, SOFA score >3.4 [1]
-
cardiovascular effects (especially
tachycardia and cardiac arrest), central nervous system effects (especially
coma), dyspnea, and diaphoresis were significantly associated with mortality [2]
- Mortality rate: 3.1% [2]
REFERENCES
1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949290/
2.https://pubmed.ncbi.nlm.nih.gov/33204096/
3.https://pubmed.ncbi.nlm.nih.gov/36987471/
4. https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-022-03742-8
edited by Yu-Jang Su 5 June 2024