Amitraz Poisoning; A case study

Archives of Disease in Childhood, 2003

Background: Amitraz is a pharmaceutical, veterinary, and agricultural product which is used worldwide under numerous generic names as an acaricide and insecticide. Because of its widespread use amitraz poisoning has come emerged as a cause of childhood poisoning during the past decade, particularly more in certain countries such as Turkey. Aims and Methods: To report the clinical features, the management, and the preventive strategies of amitraz poisoning in nine children, and review the previously reported 137 cases in humans. Results: Five male and four female children aged 10 months to 8 years were admitted to our department. The estimated ingested dose ranged between 89.2 and 163 mg/kg and estimated time from ingestion to presentation was 30-120 minutes. The initial signs and symptoms were impaired consciousness, drowsiness, vomiting, disorientation, miosis, mydriasis, hypotension, bradycardia, tachypnoea, hypothermia, and generalised seizures. Hyperglycaemia, glycosuria, and minimal increase in transaminase levels were observed. None required mechanical ventilation. CNS depression resolved spontaneously within 4-28 hours in all. The length of hospital stay was two to three days; all had a good outcome. Conclusion: This review details preventive measures and management strategies of amitraz poisoning, including the importance of following patients closely in the intensive care unit, monitoring their respiratory, cardiovascular, and central nervous systems since they may occasionally experience serious cardiopulmonary side effects.

Medical Journal of Zambia

Amitraz is a widely available insecticide but whose human poisoning is highly under-recognized and mistaken for organophosphate poisoning. As a result, it is often mismanaged possibly resulting in suboptimal clinical outcomes. We present a case of a 55-year-old man who ingested Amitraz pesticide 3 hours prior to admission following a suicide attempt.His clinical condition rapidly deteriorated necessitating admission to the Intensive Care Unit. As there is no known effective antidote for human Amitraz poisoning in current medical practice, he was managed supportively but with excellent clinical outcome. Despite the lack of an effective antidote for human Amitraz poisoning, appropriatesupportive management yields excellent clinical outcomes. However, misdiagnosis and incorrect treatment may result in severe effects on the body systems causing coma and respiratory failure which often yields fatal outcome especially in resource limited settings like Zambia.

Indian Pediatrics, 2004

Amitraz is an insecticide/acaricide of formamidine pesticides used worldwide to control ectoparasites in animals. Amitraz poisoning is a rare disorder characterized by central nervous system (CNS) and respiratory depression, bradycardia, hypotension, hypothermia, hyperglycemia,nausea and vomiting. Poisoning may occur either by oral inhalation and dermal route. In this study, we present seven pediatric patients with amitraz poisoning. The initial symptoms were unconsciousness, dizziness and vomiting; and emerged within 30-150 minutes. The length of stay in the intensive care unit (ICU) was between 18-62 hours.

2023

Amitraz is a pharmacological product widely used in the veterinary setting, in the control of ectoparasites (e.g., ticks and mites), in the treatment of demodicos in dogs, cattle etc, and in the agricultural setting as a pesticide. There have been a limited number of cases of amitraz poisoning published in the literature, as it is often under-recognised and mistaken for organophosphate poisoning (OPP). So far, there has been no specific antidote for its management. However, case reports on successfully managed patients are available and may assist doctors and other medical practitioners in the management of such cases. This index case is that of an 18-year-old male secondary school leaver who ingested an unknown quantity of an amitraz containing insecticide in a suicidal attempt and was brought to Enugu State University Teaching Hospital about 3.5 hours later, following a prior visit to a clinic close to his home. He received both symptomatic and supportive treatment, recovered fully within 3 days and was discharged on the sixth day and referred to psychiatric department for further supportive management. It is pertinent to avoid misdiagnosis as it may lead to respiratory failure, necessitating the use of ventilators which are not available in a significant number of hospitals in Nigeria.

Human & Experimental Toxicology, 2002

Amitraz, a formamidine insecticide and acaricide used in veterinary practice, presents side effects in humans related to its pharmacological activity on alpha 2-adrenergic receptors. There is little information available in the literature about the toxicology of the product in man and the treatment of this poisoning. In this report, the clinical and laboratory features of amitraz poisoning in two patients by a veterinary formulation also containing xylene are presented. The major clinical findings were unconsciousness, drowsiness, respiratory failure requiring mechanical ventilation, miosis, hypothermia and brady cardia. The laboratory findings were hyperglycemia, hypertransaminasemia and increased urinary output. Supportive management of this poisoning in humans is suggested in only a few articles and there is no specific antidote for the subsequent possible pharmacological effects of amitraz. In our two cases, we performed supportive treatment such as mechanical ventilation, atrop...

Revista de la Facultad de Medicina

El amitraz es un compuesto insecticida utilizado a nivel mundial para el control de plagas, en especial en áreas rurales agrícolas y ganaderas. La intoxicación por amitraz es infrecuente en Colombia. Se presenta el caso de una paciente de 18 años de edad, quien ingresa al servicio de urgencias 3 horas después de la ingesta de Triatox® (amitraz) en cantidad desconocida. La mujer llega con depresión del estado de conciencia, dificultad respiratoria, hipotensión, bradicardia, miosis y acidosis metabólica compensada con alcalosis respiratoria, por lo que se le suministra tratamiento inicial con medidas de soporte vital en el servicio de urgencias, con posterior necesidad de traslado y soporte en la unidad de cuidados intensivos, siendo dada de alta de la misma unidad 24 horas después del ingreso. El caso pone en consideración la similitud clínica entre la intoxicación por amitraz y la debida a otros compuestos tóxicos más frecuentes como carbamatos, organofosforados y opioides, los cual...

Indian Journal of Critical Care Medicine, 2016

Amitraz is used as a pesticide in agricultural and veterinary medicine. It is primarily a central α2 adrenergic agonist and known to cause central nervous system depression, convulsions, respiratory depression, and bradycardia on severe intoxication. We report a case of a 3-year-old child who presented with accidental ingestion of amitraz solution with signs of severe poisoning. There is no specific antidote of amitraz poisoning in humans, however, animal experiments with α2 adrenergic antagonists such as yohimbine and atimepazole have been successful. The child was managed besides intensive management with enteral yohimbine, and he regained consciousness in 18 h and was successfully weaned off mechanical ventilation.

Archivos de Medicina (Manizales), 2018

El amitraz es un insecticida utilizado en el control de plagas, el cual corresponde a un agonista adrenérgico central y periférico, cuya naturaleza aromática altamente lipofílica le permite una amplia absorción por cualquier vía de administración. Presentamos el caso clínico de un paciente de 35 años de edad, atendido en el servicio de urgencias después de la ingesta de 50 ml de Startox® (amitraz). Ingresa con somnolencia, bradicardia, hipotensión, pupilas mióticas, hiperglicemia y acidosis metabólica, por lo que se brindan medidas iniciales de soporte vital, con posterior vigilancia cardiorrespiratoria en la Unidad de Cuidados Intensivos. El cuadro refleja la proximidad clínica de la intoxicación por amitraz y la causada por otros tóxicos, en especial organofosforados y carbamatos.

Eurasian journal of toxicology, 2021

Amitraz is a drug which is used against the external parasites of domestic animals such as lice, fleas, tick species, and scabies agents. There are no indications for use in humans. In this case report, we presented the findings related to intoxication due to the intake of amitraz via dermal and inhalation route. We tried to explain the possible complications and treatment options. Oral ingestion intoxication cases due to the amitraz use have been reported in humans. In addition, several animal experiments have been conducted, but there exists very few publications in the literature related to the amitraz intake via dermal or inhalation routein humans. Here we present a case of a second-degree AV block in an adult with an acute dermal and inhalational amitraz intoxication.

Medicina Veterinária (UFRPE), 2017

Infestations by ectoparasites are one of the greatest problems in the veterinary practice, due to a large drop in performance in cattle herds and other farm animals, generating great economical losses; for pets, besides the low quality of life and disruption of homeostasis, ectoparasites represent a risk for transmission of zoonotic diseases. The formamidines emerge as a very large group of ectoparasiticides, which its main representative, amitraz, is the only one approved for animal use. Amitraz is indicated for animal use against mites, lice, and ticks for cattle, swine, and sheep. For dogs, it is used against ticks and mites. However, due to a lack of proper orientation and information, reports of accidental intoxications by amitraz, in both animals and humans, are not unusual in the literature. Amitraz intoxication has been reported in dogs, and the clinical signs are evidenced in the nervous, digestive, cardiovascular, and urinary systems and include sedation, bradycardia, bradyarrhythmias, hypotension, bradypnea, transitory hyperglycemia, mydryasis, and hypothermia, cats being more sensitive than dogs regarding these last signs. To detect amitraz and its main metabolites, there are many standardized methodologies. This review describes the pharmacokinetics, pharmacodinamics, indications, toxicological and pathological effects of amitraz, as well as the intoxication treatment and the aspects related to its detection in biological matrices.