Aluminium phosphide poisoning with severe cardiac dysfunction and the role of digoxin

Aluminium phosphide (ALP) is a common cause of suicidal poisoning in India where it is easily available and commonly known as ‘rice tablet’. In rural areas of India, it is still used to protect rice and stored grains from rodents and pests. 1 There is no specific antidote for phosphide poisoning and...

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Bibliographic Details
Published in:BMJ case reports 2017-08, Vol.2017, p.bcr-2017-220125
Main Authors: Changal, Khalid Hamid, Latief, Muzamil, Parry, Manzoor, Abbas, Farhat
Format: Article
Language:English
Subjects:
Acidosis, Lactic - chemically induced
Acidosis, Lactic - physiopathology
Acidosis, Lactic - therapy
Aluminum
Aluminum Compounds - poisoning
Asia
Cardiac arrhythmia
Cardiotonic Agents - therapeutic use
Case reports
Digoxin - therapeutic use
Electrocardiography
Fluid Therapy
Gangrene
Gastric Lavage
Global Health
Heart failure
Humans
Hypokinesia - chemically induced
Hypokinesia - physiopathology
Hypokinesia - therapy
India
Indian Sub-Continent
Male
Mortality
Pesticides - poisoning
Phosphines - poisoning
Poisoning
Poisons
Potassium
Respiration
Rodents
Shock, Cardiogenic - chemically induced
Shock, Cardiogenic - physiopathology
Shock, Cardiogenic - therapy
Suicidal behavior
Toxicity
Treatment Outcome
Ultrasonic imaging
Urine
Young Adult
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Summary:Aluminium phosphide (ALP) is a common cause of suicidal poisoning in India where it is easily available and commonly known as ‘rice tablet’. In rural areas of India, it is still used to protect rice and stored grains from rodents and pests. 1 There is no specific antidote for phosphide poisoning and treatment involves meticulous supportive care. Ingestion can lead to severe cardiac suppression and cardiogenic shock. For patients poisoned with ALP who continue to have refractory shock with persistent myocardial suppression despite the use of adrenergic inotropic agents, the addition of digoxin may be beneficial. We present a case where digoxin was utilised with beneficial patient outcomes.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-220125