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Sultan Qaboos Univ Med J. 2016 Aug;16(3):e352-5. doi: 10.18295/squmj.2016.16.03.015. Epub 2016 Aug 19.

Treatment of Aluminium Phosphide Poisoning with a Combination of Intravenous Glucagon, Digoxin and Antioxidant Agents.

Author information

1
Department of Medical Toxicology, Kerman University of Medical Sciences, Kerman, Iran;
2
Atherosclerosis & Coronary Artery Research Centre, Birjand University of Medical Sciences, Birjand, Iran; Medical Toxicology & Drug Abuse Research Centre, Birjand University of Medical Sciences, Birjand, Iran.

Abstract

Aluminium phosphide (AlP) is used to protect stored grains from rodents. It produces phosphine gas (PH3), a mitochondrial poison thought to cause toxicity by blocking the cytochrome c oxidase enzyme and inhibiting oxidative phosphorylation, which results in cell death. AlP poisoning has a high mortality rate among humans due to the rapid onset of cardiogenic shock and metabolic acidosis, despite aggressive treatment. We report a 21-year-old male who was referred to the Afzalipour Hospital, Kerman, Iran, in 2015 after having intentionally ingested a 3 g AlP tablet. He was successfully treated with crystalloid fluids, vasopressors, sodium bicarbonate, digoxin, glucagon and antioxidant agents and was discharged from the hospital six days after admission in good clinical condition. For the treatment of AlP poisoning, the combination of glucagon and digoxin with antioxidant agents should be considered. However, evaluation of further cases is necessary to optimise treatment protocols.

KEYWORDS:

Aluminum Phosphide; Antioxidants; Case Report; Digoxin; Glucagon; Iran; Phosphine; Poisoning

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