TY - JOUR PY - 2021// TI - Osmolal and anion gaps after acute self-poisoning with agricultural formulations of the organophosphorus insecticides profenofos and diazinon - a pilot study JO - Basic and Clinical Pharmacology and Toxicology A1 - Dhanarisi, Jeevan A1 - Tzotzolaki, Tanita Maria A1 - Vasileva, Ana-Mariya D. A1 - Kjellberg, Matti A. A1 - Hakulinen, Hanna A1 - Vanninen, Paula A1 - Gawarammana, Indika A1 - Mohamed, Fahim A1 - Hovda, Knut Erik A1 - Eddleston, Michael SP - ePub EP - ePub VL - ePub IS - ePub N2 - Self-poisoning with organophosphorus (OP) insecticides is an important means of global self-harm. The insecticides are formulated with solvents that may also contribute to toxicity. We set up a study to detect changes in osmolal and anion gaps following ingestion of OP insecticides. We recruited consecutive patients admitted to a Teaching Hospital, Sri Lanka, with a history of OP self-poisoning. The osmolal and anion gaps were calculated on admission and at 4, 24 and 72 h post-ingestion together with ethanol concentration. Forty-nine patients were recruited (28 profenofos, 10 diazinon, 1 coumaphos, 1 chlorpyrifos, 1 phenthoate, and 8 unknown OP). Only modest increases in osmolal and anion gaps were noted. Small rises in osmolal gap above the upper limit of normal were noted in 16/49 (32.7%) of all cases, 9/28 (32.1%) profenofos cases, and 4/10 (40.0%) diazinon cases. The anion gap was raised in 24/49 (49.0%) of all cases, 15/28 (53.6%) profenofos cases, and 5/10 (50.0%) diazinon cases. We observed a trend for a fall in osmolal gap during the first 24 h, followed by an increase up to 72 h. There was no correlation between the anion gap and serum lactate concentration, indicating that a lactic acidosis was not responsible for the anion gap. Formate, which could have explained the increased gap, was not detected in any of the samples; ketoacids (beta-hydroxy butyrate and acetoacetate) were not measured. This pilot study found that profenofos and diazinon poisoning caused only modest increases in the osmolal and anion gaps in a minority of cases.

Language: en

LA - en SN - 1742-7835 UR - http://dx.doi.org/10.1111/bcpt.13686 ID - ref1 ER -