Trimetazedine with hyperinsulinimea–euoglycemia, <i>N</i>‐acetyl cysteine, and vitamin C: A new approach concept for management of aluminum phosphide poisoning

Shehaby, Doaa M. El; Sayed, Sohair K.; El-Kareem, Doaa M. Abd; Elsherif, Raghda; Almaz, Doaa

doi:10.1002/jbt.22931

Cited by 6 publications

(1 citation statement)

References 49 publications

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“…In Egypt, aluminium phosphide is commonly used in grain storage as a fumigant pesticide (Elgazzar et al, 2022). Aluminium phosphide toxicity has a high mortality rate, almost reaching 100%.…”

Section: Discussionmentioning

confidence: 99%

Ameliorative Effects of Erdosteine and Exogenous Reduced Nicotinamide Adenine Dinucleotide Phosphate on Aluminium Phosphide Induced Cardiotoxicity in Adult Albino Rats.

Ali

elbadawy

Metwally

et al. 2022

Mansoura Journal of Forensic Medicine and Clinical Toxicology

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The present study was performed to determine the possible protective effects of erdosteine and exogenous reduced nicotinamide adenine dinucleotide phosphate (NADPH) against cardiotoxicity produced by aluminium phosphide (AlP) via measurement of serum cardiac markers and assessment of cardiomyocyte viability and apoptosis by flow cytometry analysis. Fifty-four adult albino rats were divided into seven groups as follows; four control groups (negative control, solvent control, erdosteine control, NADPH control), AlP group (12 mg/kg) orally, AlP + erdosteine (150 mg/kg) orally, AlP + NADPH (16 mg/kg) intravenously. After 8 hours, blood samples were collected from the retro-orbital plexus for analysis of serum cardiac markers, and then the chest and abdomen were carefully incised to remove the hearts for flow cytometry analysis and histopathological examination. Results revealed that AlP poisoning caused an increase in serum cardiac markers (LDH, cTnI) with a marked decrease in the viability of cardiac myocytes and a marked increase in the percent of apoptotic cardiac myocytes. Co-administration of erdosteine with AlP slightly improved serum cardiac markers and cardiomyocyte viability, with a slight decrease in the percent of apoptosis. Coadministration of NADPH with AlP showed marked improvement in serum cardiac markers, a marked increase in myocardial cell viability, and a marked decrease in the percent of apoptotic myocytes. These findings were confirmed by histopathological examination of heart tissues from each group. From the previous data, it can be concluded that administration of exogenous NADPH intravenously may be a promising antidote for AlP toxicity.

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Section: Discussionmentioning

confidence: 99%

Ameliorative Effects of Erdosteine and Exogenous Reduced Nicotinamide Adenine Dinucleotide Phosphate on Aluminium Phosphide Induced Cardiotoxicity in Adult Albino Rats.

Ali

elbadawy

Metwally

et al. 2022

Mansoura Journal of Forensic Medicine and Clinical Toxicology

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Exploring research gaps and trends in the management of acute phosphide poisoning: a systematic review

Sobh

Kholief

Sobh

et al. 2023

Critical Reviews in Toxicology

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The therapeutic benefit of antioxidants on the outcome of acute aluminum phosphide poisoning: a systemic review and meta-analysis

Sobh

Abd-Elhameed

2023

Toxicology Research

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This systematic review and meta-analysis pool evidence available from clinical trials to verify the effect of antioxidants on the outcome of acute aluminum phosphide (AlP) poisoning. A systematic review complied with “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) Protocols. Meta-analysis was conducted on 10 studies that fulfill eligibility criteria. Four antioxidants were implemented: N-Acetyl cysteine (NAC), L-Carnitine, Vitamin E, and Co-enzyme Q10 (Co Q10). Risk of bias, publication bias, and heterogeneity were assessed to ensure the results’ reliability. Antioxidants significantly decrease mortality of acute AlP poisoning around three folds (OR = 2.684, 95% CI: 1.764–4.083; P < .001) and decrease the need for intubation and mechanical ventilation by two folds (OR = 2.391, 95% CI 1.480–3.863; P < .001) compared with control. Subgroup analysis revealed that NAC significantly decreases mortality by nearly three folds (OR = 2.752, 95% CI: 1.580–4.792; P < .001), and vitamin E significantly decreases mortality by nearly six folds (OR = 5.667, 95% CI: 1.178–27.254; P = .03) compared with control. L-Carnitine showed a borderline significance (P = .050). Co Q10 decreased the mortality compared with the control; however, the difference was not statistically significant (P = .263). This meta-analysis provides solid evidence regarding the efficacy of antioxidants in improving the outcome of acute AlP poisoning with reference to NAC. Wide confidence interval and small relative weight affect reliability regarding vitamin E efficacy. Future clinical trials and meta-analyses are recommended. To our knowledge, no previous meta-analysis was conducted to investigate the efficacy of treatment modalities for acute AlP poisoning.

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Trimetazedine with hyperinsulinimea–euoglycemia, N‐acetyl cysteine, and vitamin C: A new approach concept for management of aluminum phosphide poisoning

Cited by 6 publications

References 49 publications

Ameliorative Effects of Erdosteine and Exogenous Reduced Nicotinamide Adenine Dinucleotide Phosphate on Aluminium Phosphide Induced Cardiotoxicity in Adult Albino Rats.

Ameliorative Effects of Erdosteine and Exogenous Reduced Nicotinamide Adenine Dinucleotide Phosphate on Aluminium Phosphide Induced Cardiotoxicity in Adult Albino Rats.

Exploring research gaps and trends in the management of acute phosphide poisoning: a systematic review

The therapeutic benefit of antioxidants on the outcome of acute aluminum phosphide poisoning: a systemic review and meta-analysis

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