Successful Treatment of Aluminum Phosphide Poisoning with Digoxin: A Case Report and Review of Literature
Aluminum phosphide (AlP) is a pesticide which release phosphine gas when comes in contact with water or hydrochloric acid in stomach. Phosphine is a mitochondrial poison and interferes with protein and enzyme synthesis. Cardiogenic shock secondary to toxic myocarditis remains the most common cause of death in AlP poisoning. There is citable report on the use of digoxin for treatment of cardiac failure from ALP poisoning, although it has been used effectively for other causes of cardiac failure. Here an 18-years old female is introduced who referred to poisoning center with acute AlP poisoning and cardiogenic shock. Digoxin 0.5 mg was initially used and followed by 0.5 mg every 6 h during the first day. Digoxin was continued by 0.25 mg daily for management of cardiogenic shock until the effects of AlP resolved. The patient was discharged 10 days after admission, with full recovery. The conclusion is that administration of digoxin to ALP poisoning cases help manage to cardiogenic shock and prevent from death but needs to be confirmed by further studies.
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