Aldicarb poisoning

Aldicarb (2-methyl-2 (methylthio) propanal o-[(methylamino)-carbonyl] oxime ) is a pesticide manufactured since 1965. This carbamate ester is sold unde r the tradename, Temik(R), and is used as insecticide and nematicide. The E nvironmental Protection Agency has classified aldicarb in the highest toxic ity category and has defined a strict control for its delivery and use. In Brazil and the Caribbean island, aldicarb is illegally used as a household rodenticide with a widespread risk of poisoning. Our study presents the fir st review of aldicarb poisoning circumstances associated with clinical and analytical findings. Moreover, the oxime treatment is discussed. Eighteen p atients with cholinergic symptoms admitted to the Emergency Unit and two de ceased with a history of aldicarb poisoning were included in the study. As agricultural workers, only two of them could legally use Temik(R). Seventy percent of the patients was managed by the Emergency Mobil Unit. Serum chol inesterase activity was always lower than 30% of the normal range and aldic arb was identified by UV spectra and retention time after liquid chromatogr aphy separation. The most common muscarinic effect was diarrhea, the main n icotinic sign fasciculation and almost half of the poisoned patients had ce ntral nervous system (CNS) depression (Glasgow Coma Score lower than 8). Fo ur patients had serious conduction abnormalities and two of them died. Thes e results suggest that aldicarb intoxication is always severe. Grime treatm ent did not produce side effects and should be recommended whenever the pes ticide involved is unknown. Effective measures should be implemented to sta mp out the illicit use of aldicarb.