1. VITAL
SIGNS
Hypotension, shock, and
tachycardia occur commonly.
2. CARDIOVASCULAR
Cardiac dysrhythmias and ECG
abnormalities have ben reported following zinc phosphide ingestions. Hypotension,
shock, toxic myocarditis, myocardial failure, and massive focal myocardial
injury with elevated cardiac enzymes may occur.
3. RESPIRATORY
Cough, dyspnea, cyanosis, chest
tightness, and tachypnea may occur. Pulmonary edema has been reported following
zinc phosphide ingestion. Zinc phosphide releases toxic and irritating fumes of
oxides of phosphorus and zinc oxide when heated to decomposition. Inhalation
exposure to such fumes would be predicted to result in respiratory tract
irritation with bronchospasm, chemical pneumonitis, or noncardiogenic pulmonary
edema.
4. NEUROLOGIC
Acute exposure may result in
headache, dizziness, fatigue, and CNS depression leading to coma, and chronic
exposure may lead to neuropsychiatric manifestations. Seizures are not uncommon
after acute exposure. Restlessness and anxiety may be noted following acute
zinc phosphide ingestion.
5. GASTROINTESTINAL
Nausea, vomiting, and abdominal
pain may occur. Pancreatitis has been rarely reported.
6. HEPATIC
Acute exposure may produce
jaundice with hepatomegaly. Elevations of serum transaminases may be
noted.
7. ACID-BASE
Metabolic acidosis may be seen
in acute poisonings.
8. FLUID-ELECTROLYTE
Hypokalemia
may occur secondary to profuse vomiting following zinc phosphide ingestion.
9. ENDOCRINE
Severe hypoglycemia has been reported.
10. REPRODUCTIVE
At the time of this review, no
data were available to assess the teratogenic potential of this agent.
Monitoring parameters:
1. Monitor
vital signs & mental status.
2. Monitor
continuous pulse oximetry.
3. Institute
continuous cardiac monitoring & obtain an EEG.
4. Monitor
serum electrolytes, blood glucose, renal function, and liver enzymes.
5. Obtain a
chest radiograph in patients with respiratory symptoms.
References:
- UpToDate. Available from: http://www.uptodate.com.ezp.imu.edu.my/contents/overview-of-rodenticide-poisoning?source=machineLearning&search=zinc+phosphide&selectedTitle=1%7E1§ionRank=1&anchor=H352512775#H352516540
- CDC. Available from: http://www.atsdr.cdc.gov/mmg/mmg.asp?id=1013&tid=214
- http://www.ncbi.nlm.nih.gov/pubmed/19280425
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