L-Carnitine as an Adjuvant Treatment in Acute Organophosphorus Pesticides Poisoning: A Randomized Clinical Trial

Abstract

Organophosphorus compounds are widely used pesticides. They are associated with a significant risk of acute intoxication. Oxidative stress is a contributing factor of acute organophosphorus poisoning morbidity and mortality. L-carnitine was found to have free-radical scavenging and antioxidant properties. Therefore, we aimed to evaluate the efficacy and safety of L-carnitine as an adjuvant in treatment of patients with acute organophosphorus poisoning. A randomized clinical trial was conducted on 30 patients suffering from acute organophosphorus poisoning admitted to Poison Control Center, Tanta University Emergency Hospital, Egypt, from April 2017 till January 2018. Patients were randomly divided into two equal groups. Group I received the standard treatment only and group II received the standard treatment plus L-carnitine in a dose of 1gm/8 hours IV.At time of admission, malondialdehyde, reduced glutathione, serum total antioxidant capacity and psudocholinesterase enzyme activity registered no significant difference between the two studied groups. After treatment, malondialdehyde, reduced glutathione and serum total antioxidant capacity showed significant improvement in group II. The mean value of atropine dose in group II (5.6mg) was significantly lower than group I(10.9mg). We concluded that the use of L-carnitine improved the antioxidant status and reduced total atropine dose required for treatment of patients with acute organophosphorus poisoning.

L-Carnitine ameliorates Cisplatin-induced testicular toxicity in rats

“…In this study, administration of L-carnitine alleviated the reduction in germ cell numbers, repaired the morphological damage in testicular tissues and exhibited ameliorative effects against the damage caused by cisplatin. Numerous studies agreed with our findings [25][26][27][28].…”

“…Furthermore, L-carnitine could improve antioxidant status and free radicals detoxification and provide strong antigenotoxic effect in Cisplatin intoxicated rats [27].…”

Ameliorative effect of L-carnitine on lambda-cyhalothrin-induced anatomical and reproductive aberrations in albino mice

“…It is derived from dietary sources (75%) and endogenous biosynthesis (25%) mainly in the liver and kidney, is a necessary factor for the utilization of long-chain fatty acids to produce energy in mitochondria ( Elkomy et al, 2020 , Jin et al, 2019 , Sallam et al, 2020 ). It has been shown to function as an antioxidant that scavenges reactive oxygen species (ROS); so could prevent mitochondrial oxidative stress-induced by mitochondrial damage and apoptosis in different cell types, and also elicits stabilizing effect on damaged cell membranes ( Dokmeci et al, 2006 , Edres et al, 2018 , Ghonem et al, 2018 , Sallam et al, 2020 , Sarica et al, 2007 ).…”

Molecular Mechanisms of Acute Organophosphate Nephrotoxicity

“…Nevertheless, various stabilisers that reduce oxidative stress levels are likely to have some beneficial effects. For example, L-carnitine administration improved antioxidant status and reduced the total dose of atropine required to treat patients with acute OP poisoning, provided that at the time of patient admission MDA and GSH levels, total serum antioxidant capacity, and pseudocholinesterase enzyme activity had no significant differences between the two study groups [ 146 ].…”