Affiliation:
1. Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Abstract
Due to its easy availability, rapid and severe toxicity, and no specific antidote, aluminum
phosphide has emerged as a lethal toxin, commonly used for suicidal intent in agricultural
communities. Despite various advances in medicine, this compound’s toxicity is poorly understood,
and it still has a very high case fatality rate with no definitive treatment options available.
This review aims to understand the mechanism of toxicity, clinical toxidrome of acute aluminum
phosphide poisoning, and the available therapeutic options, including recent advances. A literature
review was performed searching PubMed, EMBASE Ovid, and Cochrane Library, using the following
search items: (“aluminum phosphide poisoning” OR “aluminum phosphide poisoning toxicity”
OR “aluminum phosphide ingestion”) AND (“management” OR “therapy” OR “treatment”). Selected
articles were discussed amongst all the authors to shape this review. High case fatality rate and
lack of any specific antidote are persisting challenges. Therapeutic measures need to be implemented
from all fronts – reducing easy access to the poison, developing less toxic alternatives for use as
a pesticide, and more studies directed at developing an effective reversal agent for phosphine. The
advent of promising agents like glucose-insulin-potassium infusion and lipid emulsion is a new ray
of hope in the complete recovery in this fatal poisoning. The need of the hour is to find an agent
that rapidly and effectively reverses aluminum phosphide's toxic effects. Large multicenter controlled
trials are required to establish the role of glucose-insulin-potassium and lipid emulsion.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),Biochemistry (medical),Clinical Biochemistry,Pharmaceutical Science
Cited by
8 articles.
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