Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches

Zinc phosphide (ZnP) is a rodenticide commonly used in agriculture for pest control, but it can causeacute human poisoning, through ingestion in suicide attempts. The toxicokinetics of ZnP are not well understood, although it is believed that its primary mechanism of toxicity involves the inhibition...

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Main Authors: Sayed Mahdi Marashi, Foroozan Faress, Kurosh Jodaki, Leyla Abdolkarimi, Zeynab Nasri Nasrabadi
Format: Article
Language:English
Published: Nepal Medical Association 2025-05-01
Series:Journal of Nepal Medical Association
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Online Access:https://jnma.com.np/jnma/index.php/jnma/article/view/9048
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author Sayed Mahdi Marashi
Foroozan Faress
Kurosh Jodaki
Leyla Abdolkarimi
Zeynab Nasri Nasrabadi
author_facet Sayed Mahdi Marashi
Foroozan Faress
Kurosh Jodaki
Leyla Abdolkarimi
Zeynab Nasri Nasrabadi
author_sort Sayed Mahdi Marashi
collection DOAJ
description Zinc phosphide (ZnP) is a rodenticide commonly used in agriculture for pest control, but it can causeacute human poisoning, through ingestion in suicide attempts. The toxicokinetics of ZnP are not well understood, although it is believed that its primary mechanism of toxicity involves the inhibition of Complex IV of Cytochrome C Oxidase, similar to aluminum phosphide (ALP) poisoning. However, there are notable differences between the two. The rarity of acute ZnP toxicity and the misconception that it mirrors ALP poisoning have hindered the development of effective treatment strategies. This review critically examines the challenges of existing treatment protocols and proposes new approaches based on current evidence. A thorough literature review on the management of ZnP and ALP poisoning was conducted. Due to the delayed onset of symptoms in ZnP poisoning, aggressive gastrointestinal decontamination is recommended prior to toxin absorption. Furthermore, the potential for acute liver failure in early ZnP cases requires targeted treatment for hepatic injury. Since systemic absorption of phosphine can produce effects similar to ALP poisoning, existing ALP treatment protocols may also aid in managing ZnP toxicity. This study proposes a treatment protocol for ZnP poisoning, emphasizing the need for further randomized trials to validate its effectiveness.
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issn 0028-2715
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publishDate 2025-05-01
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spelling doaj-art-d27c7dda7d40422aa04d90c4b4627e0b2025-08-20T02:23:27ZengNepal Medical AssociationJournal of Nepal Medical Association0028-27151815-672X2025-05-016328610.31729/jnma.9048Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic ApproachesSayed Mahdi Marashi0Foroozan Faress1Kurosh Jodaki2Leyla Abdolkarimi3Zeynab Nasri Nasrabadi4Department of Forensic Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, IranDepartment of Forensic Medicine, School of Medicine, Iran University of Medical Sciences, Teharn, IranSchool of Nursing and Midwifery, Shohadaye Haft e Tir Hospital, Iran University of Medical Sciences, Teharn, IranDepartment of Forensic Medicine, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IranDepartment of pediatrics, School of Medicine, Iran University of Medical Sciences, Teharn, IranZinc phosphide (ZnP) is a rodenticide commonly used in agriculture for pest control, but it can causeacute human poisoning, through ingestion in suicide attempts. The toxicokinetics of ZnP are not well understood, although it is believed that its primary mechanism of toxicity involves the inhibition of Complex IV of Cytochrome C Oxidase, similar to aluminum phosphide (ALP) poisoning. However, there are notable differences between the two. The rarity of acute ZnP toxicity and the misconception that it mirrors ALP poisoning have hindered the development of effective treatment strategies. This review critically examines the challenges of existing treatment protocols and proposes new approaches based on current evidence. A thorough literature review on the management of ZnP and ALP poisoning was conducted. Due to the delayed onset of symptoms in ZnP poisoning, aggressive gastrointestinal decontamination is recommended prior to toxin absorption. Furthermore, the potential for acute liver failure in early ZnP cases requires targeted treatment for hepatic injury. Since systemic absorption of phosphine can produce effects similar to ALP poisoning, existing ALP treatment protocols may also aid in managing ZnP toxicity. This study proposes a treatment protocol for ZnP poisoning, emphasizing the need for further randomized trials to validate its effectiveness. https://jnma.com.np/jnma/index.php/jnma/article/view/9048managementpoisoningrodenticidezinc phosphide
spellingShingle Sayed Mahdi Marashi
Foroozan Faress
Kurosh Jodaki
Leyla Abdolkarimi
Zeynab Nasri Nasrabadi
Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches
Journal of Nepal Medical Association
management
poisoning
rodenticide
zinc phosphide
title Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches
title_full Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches
title_fullStr Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches
title_full_unstemmed Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches
title_short Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches
title_sort considerations on the management of zinc phosphide toxicity and proposed therapeutic approaches
topic management
poisoning
rodenticide
zinc phosphide
url https://jnma.com.np/jnma/index.php/jnma/article/view/9048
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AT foroozanfaress considerationsonthemanagementofzincphosphidetoxicityandproposedtherapeuticapproaches
AT kuroshjodaki considerationsonthemanagementofzincphosphidetoxicityandproposedtherapeuticapproaches
AT leylaabdolkarimi considerationsonthemanagementofzincphosphidetoxicityandproposedtherapeuticapproaches
AT zeynabnasrinasrabadi considerationsonthemanagementofzincphosphidetoxicityandproposedtherapeuticapproaches