Imidacloprid Poisoning

 

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