Clinical and toxicological data in Fenthion and omethoate acute poisoning

Abstract

This study paper reports on two cases of poisoning with the organophosphorus insecticides, fenthion and omethoate. The two victims were admitted in the Intensive Care Unit (ICU) a few hours after ingestion of the two insecticides. They received appropriate treatment for organophosphorous poisoning (gastric lavage, activated charcoal, atropine and pralidoxime) and supportive care. Both patients survived. Organophosphate blood levels were determined on admission (fenthion 2.9 micrograms/ml, omethoate 1.6 micrograms/ml) and during the hospitalisation and proved to be considerably high. Slow elimination rate of the poison already distributed in the body was indicated for both pesticides. The patient with omethoate poisoning remained clinically well (Glasgow Coma Scale: 15) and was discharged three days later. The patient with fenthion poisoning, who had also ingested 30 mg of bromazepam and 720 mg of oxetoron, developed cholinergic crisis six hours after admission and was intubated for 24 days, with concomitant complications.

Oxime therapy and outcomes in human organophosphate poisoning: An evaluation using meta-analytic techniques

“…However, given the tendency of harm with oximes observed in the current study, it is not clear if higher doses of oximes in humans would either offer benefits or increase harm. A high therapeutic level of oximes may still not be efficacious, as reports have demonstrated the occurrence of intermediate syndrome despite maintaining plasma levels of pralidoxime of Ͼ4 g/mL (37,38). Recent evidence from experimental animals also suggested that high-dose pralidoxime prolonged time to extubation and increased mortality in paraoxon-exposed minipigs (39).…”

Fatal intoxication with omethoate

“…One accidental oral intoxication with fatal outcome after 16 days occurred in Italy [19], but no case of suicidal omethoate ingestion has been reported so far. In one case of omethoate ingestion the patient, who recovered completely, showed an omethoate blood level of 1.6 µg/ml [20]. No additional data are available about omethoate concentrations in human body fluids or tissue samples in fatal poisoning cases.…”

Prospective Assessment of Patterns, Severity and Clinical Outcome of Indian Poisoning Incidents

“…17) This was probably because the onset of symptoms in fenthion poisoning is often delayed for up to several days after admission to hospital and the predominant toxicity is delayed onset of respiratory paralysis. 47,48) Therefore, in this study, we assessed the severity of patients on admission using two scoring systems (GCS and PSS), and then followed up with patient's clinical outcome (e.g., improved, discharged with severe morbidity or deceased) not only to find out the sensitivity of GCS and PSS scoring systems with the clinical outcome of poisoning, but also the correlation between GCS and PSS scoring systems.…”