Chromoxone, herbikill, partner etcetera are paraquat herbicides of bipyridyl group used widely by farming communities.
They do not affect the nervous system like Opp. They instead cause oxidative destruction of tissues and organs that culminate in major organ failure when the amount is sufficiently high. Concentrations greater than 50mls causes 100% fatality in 1-7days as a result of major organ failure.
The lungs are affected most because they preferentially concentrate paraquats wherein they get converted to free radicals whose redox reaction products depletes the body's antioxidant reservoirs in addition to oxidative destruction of lung tissue which then present as pulmonary fibrosis in a few weeks later.
The prognosis of victims depends on how soon aggressive decontamination of gut and acceleration of urinary excretion is done. This is in addition to prompt antioxidant therapy.
Atropine has zero role in paraquat poisoning. Immunosuppressants and antioxidants are the drug of choice. They include high dose cyclophosphamide, dexamethasone, vitamin C. We have treated to discharge two cases using dexamethasone and vitamin C.
Delayed treatment of paraquat poisoning will inevitably lead to death by respiratory failure in 2-4 weeks. I have seen a case treated wrongly as OPP who developed fatal fibrosis 3wks later.
To avoid such fatal mistakes we should always consult www.poisonsense.com
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