Toxicology International (Formerly Indian Journal of Toxicology)

M. Y. Bharathraj ¹, K. Venugopal ¹, Kadappa Jaligidad ¹, Halli Karibasappa ¹, Hemantha Kumar ¹

Affiliations
1 Department of General Medicine, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, IN

Abstract

Fipronil is a broadspectrum N-phenylpyrazole insecticide with gamma-aminobutyric acid type A receptor inhibitory action causing hyperexcitability of central nervous system. There is no literature reported in the past concerning its acute toxicity in human beings. A case report is useful for workers in medical and veterinary field. Hence, we are reporting a case in which young male intoxicated with fipronil compound was presented to the emergency department for having generalized tonic-clonic seizures and subsequently with the features of delirium for few days. This patient was treated with benzodiazepines which controlled the seizures and antipsychotics were given for few days for treating the psychosis.

Keywords

Fipronil, GABA Inhibitors, Midazolam, Psychosis, Seizures.

Full Text

     

Venugopal K ¹, Mallikarjun Reddy M. ¹, Bharathraj M. Y. ¹, Kadappa Jaligidad ¹

Affiliations
1 Department of General Medicine, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, IN

Abstract

Pheniramine maleate is an easily accessible, over‑the‑counterantihistaminic, which is frequently involved in overdoses. Pheniramine has antimuscarinic effect causing tachycardia, dilated pupils, urinary retention, and dry flushed skin, and decreased bowel sounds, confusion, mild increase in body temperature, cardiac arrhythmias, and seizures at lethal doses. It has not been implicated as an important cause of rhabdomyolysis and acute kidney injury (AKI). Rhabdomyolysis causing AKI is rarely reported in the literature. This case report emphasizes the occurrence of nontraumatic rhabdomyolysis in pheniramine maleate overdose which required hemodialysis. Since there is a lack of a specific antidote, treatment is mainly symptomatic and supportive. We report a fatal case of a young male with a very high dose of consumption of pheniramine maleate (4.077 g), which was complicated by seizures, respiratory depression, nontraumatic rhabdomyolysis, and AKI. Despite hemodialysis, ventilator support, and other intensive supportive care, patient could not survive and death ensued due to multiorgan dysfunction syndrome.

Keywords

Acute kidney injury, convulsions, drug‑induced rhabdomyolysis, pheniramine maleate overdose, respiratory depression

Full Text