Massive Ingestion of the Herbicide 2-Methyl-4-Chlorophenoxyacetic Acid (MCPA)

Schmoldt, A.; Iwersen, Stefanie; Schlüter, W

doi:10.3109/15563659709043374

Cited by 19 publications

(11 citation statements)

References 7 publications

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“…Schmoldt et al (31) described a patient who presented within two hours of ingesting 50 -100g MCPA (as the dimethylammonium salt). A forced diuresis was instituted within the first few hours of admission (day 1) when the plasma MCPA concentration was 546 mg/L, but by day 4 the plasma MCPA concentration had fallen only to 379 mg/L.…”

Section: -Chloro-2-methylphenoxyacetic Acid (Mcpa)mentioning

confidence: 98%

Position Paper on Urine Alkalinization

Proudfoot¹,

Krenzelok

Vale³

2004

Journal of Toxicology: Clinical Toxicology

212

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This Position Paper was prepared using the methodology agreed by the American Academy of Clinical Toxicology (AACT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT). All relevant scientific literature was identified and reviewed critically by acknowledged experts using set criteria. Well-conducted clinical and experimental studies were given precedence over anecdotal case reports and abstracts were not considered. A draft Position Paper was then produced and presented at the North American Congress of Clinical Toxicology in October 2001 and at the EAPCCT Congress in May 2002 to allow participants to comment on the draft after which a revised draft was produced. The Position Paper was subjected to detailed peer review by an international group of clinical toxicologists chosen by the AACT and the EAPCCT, and a final draft was approved by the boards of the two societies. The Position Paper includes a summary statement (Position Statement) for ease of use, which will also be published separately, as well as the detailed scientific evidence on which the conclusions of the Position Paper are based. Urine alkalinization is a treatment regimen that increases poison elimination by the administration of intravenous sodium bicarbonate to produce urine with a pH > or = 7.5. The term urine alkalinization emphasizes that urine pH manipulation rather than a diuresis is the prime objective of treatment; the terms forced alkaline diuresis and alkaline diuresis should therefore be discontinued. Urine alkalinization increases the urine elimination of chlorpropamide, 2,4-dichlorophenoxyacetic acid, diflunisal, fluoride, mecoprop, methotrexate, phenobarbital, and salicylate. Based on volunteer and clinical studies, urine alkalinization should be considered as first line treatment for patients with moderately severe salicylate poisoning who do not meet the criteria for hemodialysis. Urine alkalinization cannot be recommended as first line treatment in cases of phenobarbital poisoning as multiple-dose activated charcoal is superior. Supportive care, including the infusion of dextrose, is invariably adequate in chlorpropamide poisoning. A substantial diuresis is required in addition to urine alkalinization in the chlorophenoxy herbicides, 2,4-dichlorophenoxyacetic acid, and mecoprop, if clinically important herbicide elimination is to be achieved. Volunteer studies strongly suggest that urine alkalinization increases fluoride elimination, but this is yet to be confirmed in clinical studies. Although urine alkalinization is employed clinically in methotrexate toxicity, currently there is only one study that supports its use. Urine alkalinization enhances diflunisal excretion, but this technique is unlikely to be of value in diflunisal poisoning. In conclusion, urine alkalinization should be considered first line treatment in patients with moderately severe salicylate poisoning who do not meet the criteria for hemodialysis. Urine alkalinization and high urine flow (approximately 600 mL/h) should also be ...

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Section: -Chloro-2-methylphenoxyacetic Acid (Mcpa)mentioning

confidence: 98%

Position Paper on Urine Alkalinization

Proudfoot¹,

Krenzelok

Vale³

2004

Journal of Toxicology: Clinical Toxicology

212

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“…Chez des volontaires sains, une étude cinétique de l'élimination du 2,4-D et du MCPA rapporte une demi-vie de l'ordre de 12 h pour ces deux substances [11], lorsque la dose administrée est faible. En revanche, d'autres études rapportent, pour le MCPA, une demi-vie plasmatique de l'ordre de 133 h [2] et de 80-120 h [10] en cas d'intoxication par de fortes doses. Il apparaît cependant que ces demi-vies plasmatiques sont considérablement diminuées par l'alcalinisation des urines [2,12] et la réalisation de séances d'hémodialyse [9].…”

Section: Résultats Et Discussionunclassified

“…L'emploi d'herbicides aryloxyacides est largement répandu depuis les années 50 [1] en Europe, aux États-Unis et en Asie en tant que désherbants systémiques, du fait de l'analogie de leur structure avec les phytohormones auxiniques [2]. D'un Correspondance : Isabelle Morel, Tél.…”

Section: Introductionunclassified

Cas clinique : suivi d'une intoxication volontaire au Printazol par LC-MS/MS

Lepage¹,

Gacouin

Baert³

et al. 2009

Ann Toxicol Anal

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Résumé - Mots clés : Printazol, chlorophénoxy-herbicide, intoxication aiguë, LC-MS/MSAbstract -Objective: A 49-years old man was admitted to intensive care unit after ingestion of an undetermined volume of Printazol solution, actually a mixture of chlorophenoxyacid herbicides composed of 2,4-D (2,4-dichlorophenoxyacétic acid), MCPA (2-methyl-4-chlorophenoxyacétic acid) and picloram. The purpose of this study is to consider the evolution of the intoxication, in terms of clinical and biological parameters, and quantification of the herbicides. Methods: The intoxication was treated using alkaline diuresis and iterated hemodialysis. Blood and urinary levels of herbicides were monitored during 7 days by means of LC-MS-MS analysis. Results and conclusions: LC-MS-MS analysis proved fast (performing time: 20 minutes) and sensitive (LOD < 0.1 mg/L for every analyte). This method permitted to fine-tune the treatment, and contributed to the positive evolution of the clinical state of the patient and his transfer to another hospital unit.

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“…Renal failure (Meulenbelt et al, 1988). A case of MCPA poisoning was reported by Schmoldt, Iwersen, and Schl€ u uter (1997). The patient suffered burning of the mouth, pain in the extremities, and hypotension.…”

Section: Human Poisoningsmentioning

confidence: 99%

“…The patient suffered burning of the mouth, pain in the extremities, and hypotension. Alkalinization of the urine is reportedly effective in the management of poisoning with MCPA and dichlorprop but its effect on mecoprop elimination is less impressive (Proudfoot, 1999b;Schmoldt, Iwersen, and Schl€ u uter, 1997).…”

Section: Human Poisoningsmentioning

confidence: 99%

Toxicology of Herbicides

Marrs

2003

Pesticide Toxicology and International Regulation

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Massive Ingestion of the Herbicide 2-Methyl-4-Chlorophenoxyacetic Acid (MCPA)

Cited by 19 publications

References 7 publications

Position Paper on Urine Alkalinization

Position Paper on Urine Alkalinization

Cas clinique : suivi d'une intoxication volontaire au Printazol par LC-MS/MS

Toxicology of Herbicides

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