title: Repeated measurements of aldicarb in blood and urine in a case of nonfatal poisoning.
abstract: A nonfatal case of poisoning involving aldicarb, an extremely toxic carbamate pesticide, is presented. A 39-year-old female ingested an unknown amount of aldicarb, together with alprazolam and sertraline. On admission to ICU (T0), she displayed marked cholinergic symptoms and a deep coma. The patient was given pralidoxime and atropine. Her condition gradually improved on days 2 and 3 and she was discharged at T0+80 h. Aldicarb was assayed by high-performance liquid chromatography on 21 blood and 8 urine samples successively taken during hospitalization. At the same time, serum pseudocholinesterase activity was followed on 21 successive samples. Blood aldicarb level was 3.11 microg/mL at T0 and peaked at T0+3.5 h (3.22 microg/mL), then followed a two-slope decay with a terminal half-life of ca. 20 h. Aldicarb was detected in all urine samples (peak level: 6.95 microg/mL at T0+31.5 h) and was still present at the time of discharge. Serum pseudo-cholinesterase activity remained low (< or = 10% of normal) until the 30th hour then rapidly increased and returned to normal after the 60th hour. The patient's clinical picture closely followed blood aldicarb levels and serum pseudo-cholinesterase activities. To our knowledge, this is the first report of an aldicarb poisoning documented by repeated measurements of the drug in the intoxicated person.
authors.affiliation: Institut de Médecine Légale, Faculté de Médecine de Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Tracqui
authors.forename: F
authors.initials: F
authors.lastname: Flesch
authors.forename: P
authors.initials: P
authors.lastname: Sauder
authors.forename: J S
authors.initials: JS
authors.lastname: Raul
authors.forename: A
authors.initials: A
authors.lastname: Géraut
authors.forename: B
authors.initials: B
authors.lastname: Ludes
authors.forename: A
authors.initials: A
authors.lastname: Jaeger
mesh_terms: D000328:Adult; D000448:Aldicarb / Q000032:analysis / Q000493:pharmacokinetics* / Q000506:poisoning*; D001285:Atropine / Q000627:therapeutic use; D002091:Butyrylcholinesterase / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006207:Half-Life; D006801:Humans; D007306:Insecticides / Q000032:analysis / Q000493:pharmacokinetics* / Q000506:poisoning*; D011041:Poisoning / Q000188:drug therapy / Q000378:metabolism*; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D007306:Insecticides; D011220:Pralidoxime Compounds; D001285:Atropine; D000448:Aldicarb; D002091:Butyrylcholinesterase; C028797:pralidoxime