Comprehensive review of the mechanistic approach and related therapies to cardiovascular effects of aluminum phosphide

Abstract

Aluminum Phosphide (ALP) is an active ingredient of fumigant pesticide which is commonly used in developing countries in order to control pests in stored grain. Acute poisoning with ALP usually occurs in committed suicide through ingestion of its tablets. ALP releases fatal phosphine gas in contact with hydrochloric acid of the stomach. Its detrimental clinical features may range from nausea and headache to vital organ failure and death. However, cardiovascular complications and refractoiy hypotension are the main cause of death. The exact mechanism of phosphine has not been proved in humans. However, it seems to work as a mitochondrial toxin with inhibition of cytochrome oxidase and cellular oxygen utilization. Since there is no specific antidote for acute ALP poisoning, management of cardiovascular disorders can be an appropriate approach to save poisoned patients. This article reviews cardiovascular toxicities associated with ALP and current therapeutic approaches and tries to clarify possible ways to treat this complication. © 2013 Asian Network for Scientific Information.