title: Thirty-five cases of S-carboxymethylcysteine use in paraquat poisoning.
abstract: The herbicide paraquat is associated with a high mortality rate. It produces multiorgan damage through the induction of acute oxidative stress, by generation of reactive oxygen species that cause oxidative damage to biomolecules. In addition to general supportive measures, the management of paraquat poisoning includes gastric washing, forced diuresis, haemodialysis and the use of antioxidants, such as N-acetylcysteine. However, this drug is rather unavailable in Venezuela and S-carboxymethylcysteine has been used. We report 35 patients with mild to severe paraquat poisoning, which beside standard supportive treatment received 1500 mg S-carboxymethylcysteine, up to 2-3 w. The mortality rate was 22.86% (8 deaths/35 cases) and was related to the severity of paraquat poisoning (as assessed by urine dithionite tests). We conclude that S-carboxymethylcysteine is a reliable alternative in managing patients with paraquat poisoning.
authors.affiliation: Unidad de Ensayos Clínicos, Sección de Farmacología, Decanato de Medicina, Universidad Centroccidental Lisandro Alvarad, Barquisimeto, Estado Lara, Venezuela.
authors.forename: Nelly
authors.initials: N
authors.lastname: Lugo-Vallín
authors.forename: Idania
authors.initials: I
authors.lastname: Maradei-Irastorza
authors.forename: Carmine
authors.initials: C
authors.lastname: Pascuzzo-Lima
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramírez-Sánchez
authors.forename: Claudia
authors.initials: C
authors.lastname: Montesinos
mesh_terms: D000328:Adult; D002233:Carbocysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D005100:Expectorants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D008297:Male; D008499:Medical Records; D010269:Paraquat / Q000506:poisoning*; D011041:Poisoning / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014687:Venezuela / Q000453:epidemiology
chemical_list: D005100:Expectorants; D006540:Herbicides; D002233:Carbocysteine; D010269:Paraquat