Acute Imidacloprid Poisoning in Thailand.
humans
imidacloprid
neonicotinoid insecticide
poisoning
toxicity
Journal
Therapeutics and clinical risk management
ISSN: 1176-6336
Titre abrégé: Ther Clin Risk Manag
Pays: New Zealand
ID NLM: 101253281
Informations de publication
Date de publication:
2020
2020
Historique:
received:
02
07
2020
accepted:
26
09
2020
entrez:
18
11
2020
pubmed:
19
11
2020
medline:
19
11
2020
Statut:
epublish
Résumé
Imidacloprid is the most commonly used neonicotinoid insecticide worldwide. Despite its reputation for safety, there is increasing evidence regarding its toxicity. This study characterized the clinical manifestations and outcomes of acute imidacloprid poisoning. This was a retrospective study of patients with imidacloprid poisoning who were referred to the Ramathibodi Poison Center in Bangkok, Thailand between 2010 and 2018. A total of 163 patients with imidacloprid-only exposure were included. Most were exposed by ingestion (93.3%). The patients were predominantly male (55.8%), with a median age of 41.3 years. The common presenting features were gastrointestinal symptoms (63.8%) with no corrosive injuries and neurological effects (14.2%). The majority of medical outcomes was no (18.4%) to mild (76.1%) toxicity. One patient had symptoms mimicking cholinergic syndrome, three developed liver injury, and five died. Among the five deaths, two patients presented severe initial severity, and one presented moderate initial severity. Two of the patients who died initially presented only mild severity. The mortality rate was 3.1%. The estimated amount of ingestion, cardiovascular effects (especially tachycardia and cardiac arrest), central nervous system effects (especially coma), dyspnea, and diaphoresis were significantly associated with mortality. Patient management primarily included supportive and symptomatic care. Most patients with imidacloprid poisoning developed only mild toxicity. The mortality rate was low, but a few patients with mild initial severity died. Patients who ingest a large amount or show these warning signs including cardiovascular effects, central nervous system effects, dyspnea, and diaphoresis at the initial presentation should be considered for close observation and monitoring.
Identifiants
pubmed: 33204096
doi: 10.2147/TCRM.S269161
pii: 269161
pmc: PMC7667159
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1081-1088Informations de copyright
© 2020 Sriapha et al.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of this paper.
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