Received Date: January 23, 2019; Accepted Date: February 05, 2019; Published Date: February 15, 2019
Citation: Basiri MR (2019) Hypothesize to Designing Antidotes to Treatment of Aluminum Phosphide Poisoning. J Med Toxicol Clin Forensic Med Vol.5 No.1:1
Aluminum phosphide as rice pesticide has the public use in Iran. Phosphorus available in brass tablets immediately after dissolving and becoming is absorbed in the blood stream and is converted to compound of PH3 or phosphine. Therefore the devastating and deadly cause of the toxicity compound is PH3 which place of function or its damage target is heart. Unfortunately because the lack of suitable antidote and appropriate therapies to poisoned person who comes to the emergency hospital and just death several hours after their poisoning. Annually at least some poisoned people with ALP tablets were death in Sina hospital of Tabriz/ Iran. So according to mortality reports this publish try to showing and finding proper antidote and treatment.
ALP Tablet (Aluminum phosphide); Phosphine; Poisoning; Antidote; Antioxidants hydroquinone; Physician’s supervision
The tablets may be available children and old folks caused an accidental poisoning and may have committed used for suicide attempts in teen and young people at home. Because if it is not applying the certainly appropriate therapeutic action for the poisoned patient they will even be died. So it looks like that using proper antidote this death and devastating factor in the body is removed and its operation is inhibited or neutralized. Unfortunately because the lack of suitable antidote and appropriate therapies poisoned person that comes to the hospital and just deaths several hours after their poisoning. Of course nowadays in the final stages of treatment in hospitals in order to prevent the patient's deaths blood replacement have also been reported in Tehran/Iran .
The ALP tablets immediately dissolved in stomach pH and absorbed in the gastrointestinal. So not only ¼ of tablet will dissolve and cause the person to be poisoned but also even with the release of 1/6 pills, death reports have been happened. Phosphorus available in brass tablets immediately after dissolving and becoming absorbed in the blood stream is converted to compound of PH3 or phosphine. Therefore the devastating and deadly cause of the toxicity compound is PH3 which place of function or its target is heart. And with the make of a dysrhythmia it causes the death of poisoned person. Of course nowadays in the final stages of treatment in hospitals in order to prevent the patient's deaths safety blood replacement have also been reported.
Potassium permanganate is the first antidote used in the early stages of Aluminum phosphide tablets swallowing. This prevents from the tablet opening and dissolving. Medications and supportive treatment such delete of free radicals and toxins residues should be considered under the physician’s undervision. Despite of specialist physician trying in emergency of hospitals in a randomized annual mortality reports are available at poisoning treatment centers in Iran, especially in Sina Hospital of Tabriz/ Iran. Also annually at least some poisoned people with ALP tablets were death in Loghman hospital of Tehran/Iran.
So it looks like that using proper antidote this death factor in the body is removed and its operation is inhibited or neutralized. Estimate the appropriate antidote as a view point insilico toxicology hypothesis with respect to molecular properties of PH3 structure with it’s including Electron pairs. Because phosphine has a link with drugs with specificity such low risk and strong electrophile properties [2-4]. Some of these antidotes are recommended with nontoxic doses such as combination of ortho- and para-hydroquinone, and carnosic acid or carnosol compounds that are found in the herb rosemary (Rosmarinus officinalis) and other drugs such Acetaminophen and phenobarbital [5-7] in the first stage of poisoning, it consider combination of usage drugs these drugs strongly connect to PH3 molecules. And although with regard to above mentioned medications as well as after dissolving and absorbing in the body they create dangerous free radicals too. So in the next step to increase the defensiveness activities to remove of free radicals application of hemoperfusion, hemofiltration, hemodialysis are recommended [8-10]. Then poisonous persons must use the appropriate antioxidant drugs with specify of low risk such vitamin E and vitamin C and curcumin and other medication such as digoxin in nontoxic doses to poisoning treatment proposal. Of course, other supportive therapy proceedings should also be applying under undervision of the specialist physicians [11-13].
Attention to incidence and mortality of aluminum phosphide poisoning in the around of the world it considers the finding of proper antidote is necessary. Because nowadays it is not found real antidote to this poisoning, so this study recommends that according to state of insilico toxicology methods giving hypothesize to designing antidotes to treatment of Aluminum phosphide poisoning is requirement to treatment.
We acknowledge that all Aluminum phosphide poisoning victims in this investigation. We have special thanks of from all clinics that work undervision of welfare organization in Tabriz/Iran. We are grateful from physicians and professors in Sina hospital at the medical sciences university of Tabriz/Iran.