Chemical Reaction between Boric Acid and Phosphine Indicates Boric Acid as an Antidote for Aluminium Phosphide Poisoning

Soltani, Motahareh; Shetab-Boushehri, Seyed Farid; Shetab-Boushehri, Seyed Vahid

doi:10.18295/squmj.2016.16.03.007

Cited by 13 publications

(8 citation statements)

References 21 publications

(56 reference statements)

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“…Based on in vitro studies, 6-aminonicotinamide showed protective activity in hepatocytes [ 60 ]. Finally, although not fully investigated, boric acid theoretically seems to be a potential antidote by trapping PH 3 [ 61 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

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Antidotes for aluminum phosphide poisoning – An update

et al. 2018

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Aluminum phosphide (AlP), an inexpensive solid fumigant, is frequently used for grain conservation despite its alleged high toxicity. Increased utilization of AlP for agricultural and non-agricultural purposes during the last four decades has resulted in increment of AlP-attributed poisoning numbers. Moreover, due to its limitless accessibility in developing countries, AlP has been increasingly used for suicide. Moisture-exposed AlP undergoes a chemical reaction producing phosphine gas, which in turn inhibits cytochrome oxidase and impedes cellular oxygen consumption. Lethality remains elevated reaching rates of >50% and no effective antidote is available. Nevertheless, experimental and clinical studies suggested that magnesium sulfate, melatonin, N-acetylcysteine, glutathione, sodium selenite, vitamin C and E, triiodothyronine, liothyronine, vasopressin, milrinone, Laurus nobilis L., 6-aminonicotinamide, boric acid, acetyl-L-carnitine and coconut oil, may serve as antidotes by reducing the deleterious oxidative properties of AlP. This article reviews the afore-mentioned chemicals suggested to specifically treat AlP poisoning and discusses their protective mechanisms and main outcomes.

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Section: Discussionmentioning

confidence: 99%

“…One-gram AlP tablets were added to 200 ml of various solvents including distilled water, activated charcoal diluted in distilled water and saturated boric acid solution [ 62 ]. Each solution was used at both normal and acidified pH and separately examined.…”

Section: -Aminonicotinamide (6-an)mentioning

confidence: 99%

Antidotes for aluminum phosphide poisoning – An update

et al. 2018

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“…In addition, activated charcoal can absorb phosphine gas. [6][7][8][9] Although the exact time of toxicity was not known, we performed gastric lavage with potassium permanganate and sodium bicarbonate. Rapid use of activated charcoal and gastric lavage with potassium permanganate and sodium bicarbonate can potentially be used in patients with AlP toxicity.…”

Section: Discussionmentioning

confidence: 99%

Incidental Aluminum Phosphide Poisoning: Case Report and Current Management

Cakin¹,

Tazegül²,

Gümüş³

et al. 2018

Folia Medica

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Aluminum phosphide (AlP) is a commonly used cheap rodenticide, insecticide, and fumigant. Most intoxications in the literature are suicidal ingestions, however, AlP may cause incidental inhalational toxicities as well. After ingestion or inhalation, nausea, vomiting, dyspnea and abdominal pain develops within minutes. Hallmark of toxicity is refractory hypotension, cardiac failure and severe metabolic acidosis developing within a matter of hours are the major cause of mortality. In Turkey, AlP tablets are widely accessible and are sold without any restrictions. However, there are few local case reports in the literature. Additionally, incidental AlP intoxications are rarely reported. Herein, we present a 25-year-old male patient incidentally poisoned with AlP. He was found unconscious in a grain storage unit protected by aluminum phosphide tablets. He had hypotension and tachycardia. Arterial blood gas analysis did not reveal metabolic acidosis. He was quickly intubated and admitted to Intensive Care Unit (ICU). Supportive care crystalloid solution, n-acetyl cysteine and norepinephrine infusion was administered. After 36 hours, he was extubated and discharged without any complications. There is no specific antidote or treatment for AlP toxicity. Literature is controversial regarding treatment approach. Inhalational toxicity may occur under extreme conditions, as presented in this case report. Preventive strategies should be considered to reduce incidents. Clinicians should also be aware that AlP is a widely available and highly toxic compound that has no specific antidote and toxicity needs to be urgently treated with best supportive care.

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“…Boric acid is considered as a safe product and its toxicity is unusual (Kaymaz 2015), so we tried in our study to test the possible use of this substance as an antidote for ALP poisoning in rat models, based on the theoretical study of Soltani et al, (2016).…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Aluminum Phosphide Toxicity in Rat Model With a Novel Intervention, a Trial of Boric Acid

Sweilum

Kandeel

Noya

2017

The Egyptian Journal of Forensic Sciences and Applied Toxicolog

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Aluminum phosphide (AlP) or rice tablet is a cheap pesticide. When it comes in contact with acid (gastric acid) or moisture, it releases phosphine (PH3) gas. The heart, lungs, liver are the main targets in acute Aluminum phosphide (AlP) poisoning. Most deaths occur due to cardiovascular toxicity. Recently, boric acid has been proposed theoretically as an antidote for AlP poisoning. With the formula B (OH)3, boric acid can accept electrons as it is a Lewis acid with an empty p orbital. The aim of the present study was to investigate the possible protective role of boric acid in management of aluminum phosphide poisoning and its possible use as an effective antidote to reduce ALP poisoning mortality. Forty albino rats, all of which were adults and males were equally divided into four groups, group 1: control (given distilled water), group 2: given boric acid only (100mg/kg nontoxic dose), group 3: given aluminum phosphide (12.5 mg/kg), group 4: given aluminum phosphide followed by boric acid. Rats in group 1 and 2 was killed by cervical dislocation, while rats in group 3 and 4 were left to die, then all were dissected out. Fixation in situ was performed by perfusion technique then the chest and the abdomen were carefully incised to reveal the heart and the liver. The liver and the heart were washed with saline then quickly dissected, excised then blotted for histological preparation. Blood samples were collected from each rat (immediately after death) for measuring liver enzymes (SGOT, SGPT, ALK (alkaline phosphatase) and cardiac troponin. Rats treated with ALP followed by boric acid showed significant increase in their survival time, marked improvement in histopathological changes and also showed significant improvement in biochemical parameters including liver and cardiac markers (SGOT, SGPT, and cardiac troponin) compared with rats intoxicated with AlP. Conclusion: This study may increase the hope of using boric acid as a new effective antidote for ALP poisoning and opens the door of opportunity for larger experimental and then clinical trials to reevaluate the role of boric acid in acute ALP poisoning.

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Chemical Reaction between Boric Acid and Phosphine Indicates Boric Acid as an Antidote for Aluminium Phosphide Poisoning

Cited by 13 publications

References 21 publications

Antidotes for aluminum phosphide poisoning – An update

Antidotes for aluminum phosphide poisoning – An update

Incidental Aluminum Phosphide Poisoning: Case Report and Current Management

Management of Acute Aluminum Phosphide Toxicity in Rat Model With a Novel Intervention, a Trial of Boric Acid

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