Substance:
Emamectin – A semi-synthetic avermectin
derivative used as an insecticide. It acts by activating glutamate-gated
chloride channels in invertebrates, leading to paralysis and death [1].
- Similar to ivermectin, it can also
affect GABA-mediated neurotransmission at higher doses.
[2]
-a
broad-spectrum insecticide [3].
-
Poisoned age: 42.8 to 72 years old. [1, 3, 4]
-
Happened to Male 72.7% [3].
Common
Names:
Emamectin; commonly found in
agricultural products under trade names such as Proclaim, Affirm, or Tree-äge.
It is not intended for human or
veterinary use.
因滅汀; 迅雷; 霸蟲清; 治蟲王, 阿巴汀. [5].
Involving
Systems:
Primarily affects:
-
Potential mechanisms of corrosive injury
include skin and eye irritation effects of EMB, the solvents of which might
exert corrosive action [1, 6].
-
Central Nervous System (CNS) [1]. 27.3% [3],[4], and [6].
-
Gastrointestinal System (GI) distress [1] 62.5% [3], and [6].
-
Respiratory symptoms (6.8%) [3]. 9-27 % intubation. [3,
and 4].
-
SOB 33% [4].
Presentation:
Symptoms vary by dose and individual
sensitivity, and may include:
-
Altered mental status, AMS [1] can breach the blood-brain barrier
-
Drowsiness [4],
dizziness, ataxia, muscle weakness
-
Sore throat. [1,
6] laryngeal corrosive injuries.
-
22% Nausea, vomiting [4], abdominal pain [5], diarrhea
-
Severe
cases: respiratory depression [5], prolonged
coma
Antidote:
-
No specific antidote available [1] Supportive
care is the cornerstone of treatment:
-
Maintain airway and provide oxygen as
needed; intubation in severe cases
-
Monitor and support vital signs
-
Activated charcoal may be administered
if within 1 hour of ingestion and no aspiration risk [5].
Disposition:
Mild cases: Can be monitored as
outpatient for 6 hours;
Asymptomatic patients may be discharged
-Hospitalized (78% to 78.4%) [3, 4].
Moderate to severe toxicity: Requires
inpatient observation; ICU care (42%) may be necessary in severe CNS or
respiratory depression. [1, 4]
-
2.3%
mortality. Consciousness is a prognostic outcome. [3].
A low GCS at presentation and SOB were associated with worse outcomes [4].
References
[1].
Pan CS, Lee CC, Yu JH, Mu HW, Hung DZ, Chen CH. Reassessing clinical
presentations of emamectin benzoate poisoning: A comprehensive study. Hum Exp
Toxicol. 2024 Jan-Dec;43:9603271241249965. doi: 10.1177/09603271241249965.
PMID: 38662433
[2]. Lalmalsawmi
R, Ravikumar YS, Mahesh M, Shihuna PMM, Ramesh M, Chalasani SH. Management and
prognosis of acute Emamectin Benzoate poisoning in a human. Toxicol Rep. 2024
Sep 21;13:101744. doi: 10.1016/j.toxrep.2024.101744. PMID: 39399096; PMCID:
PMC11470463.
[3].Trakulsrichai
S, Sittiyuno P, Tansuwannarat P, Tongpoo A. Emamectin Poisoning in Thailand:
Clinical Characteristics and Outcomes. Toxics. 2024 Sep 13;12(9):668. doi:
10.3390/toxics12090668. PMID: 39330596; PMCID: PMC11435638.
[4]. Wu
YK, Chang CH, Yu JH, Lan KP, Yen TH, Chang SS, Seak CJ, Chang HY, Chen HY.
Intentional avermectin pesticide ingestion: a retrospective multicenter study.
Clin Toxicol (Phila). 2022 Oct;60(10):1099-1105. doi:
10.1080/15563650.2022.2104729. Epub 2022 Aug 2. PMID: 35916769.
[5].
https://www.sem.org.tw/Ejournal/Detail/549.
[6.].
Pan CS, Chen CH, Mu HW, Yang KW. Review of Emamectin Benzoate Poisoning. J
Acute Med. 2024 Sep 1;14(3):101-107. doi: 10.6705/j.jacme.202409_14(3).0001.
PMID: 39229355; PMCID: PMC11366691
Edited by Yu-Jang Su on April 12, 2025.
