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For further information, see CMDT Part 38-48: Paraquat Poisoning

Key Features

  • Used as a herbicide; sale is controlled

Clinical Findings

  • Concentrated solutions are highly corrosive to oropharynx, esophagus, and stomach

  • After absorption, fatal dose may be as small as 4 mg/kg

  • If ingestion of paraquat is not rapidly fatal because of its corrosive effects, the herbicide may cause progressive pulmonary fibrosis, with death ensuing after 2–3 weeks

Diagnosis

  • Clinical

  • Patients with plasma paraquat levels above 2 mg/L at 6 hours or 0.2 mg/L at 24 hours are likely to die

Treatment

  • Administer 60 g of activated charcoal by gastric tube every 2 hours for at least three or four doses

  • Anecdotal reports of benefit with cyclophosphamide and dexamethasone

  • Supplemental oxygen should be withheld unless the PO2 is < 70 mm Hg because oxygen may contribute to the pulmonary damage

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