Volume 20 No 12 (2022)
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An Overview about Acute Aluminum Phosphide Poisoning (Wheat Pill)
Shymaa M. N. Abdulrhman, Raghda H. Deraz, Laila ME Sabik
Acute Aluminum phosphide poisoning is a case of emergency with dangerous clinical findings up to shock and death within several hours. Therefore, aggressive intervention and careful life support are immediately essential based on history and clinical evidence to maintain patient life. The mode of acute Aluminum phosphide poisoning (AlP) can be accidental, suicidal, or homicidal. The lethal dose of AlP in humans after oral poisoning is reported to be 150-500 mg/70kg approximately.After oral administration of AlP phosphine gas (PH3) is released in the stomach and absorbed through the respiratory tract causing severe toxicity.Early symptoms of poisoning start in 10-15 minutes including GIT irritation (Nausea, vomiting, epigastric pain), shortness of breath, irritability, and anxiety. Garlic or spoiled fish odor from the patient’s breath is also detected. Delayed symptoms include dysphagia, delirium, seizure, coma, and shock. Common complications in adult patients include respiratory distress syndrome and pulmonary edema in addition to the accumulation of bloody or full-protein effusion in the pleural space.Aluminum phosphide poisoning is diagnosed by clinical suspicion and history. Treatment should be started immediately on suspecting AlP without waiting for confirmatory test results. The investigations are done to follow up the case, manage the outcome adequately and predict the fate. As there is no specific antidote for AlP poisoning, therefore the cornerstone of therapy is supportive care. AlP poisoning is suspected based on the history and physical examination. Treatment must not be delayed until test results are confirmed. All symptomatic patients should be monitored in the intensive care unit (ICU) for at least 72 hours. There are new trials of treatment introduced to improve the outcome as antioxidants, corticosteroids, and cardiac supportive drugs.
Aluminum Phosphide Poisoning
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