Acute phenthoate self-poisoning: a prospective case series

Figures & data

Table 1. Phenthoate properties.

	Phenthoate. CAS 2597-03-7
Structure
WHO hazard class	Class II
Rat oral LD50	∼400 mg/kg
Alkyl groups	Dimethoxy
Log Kow	3.69
Oxon or thion	Thion
Formulation	Commonly 50% emulsifiable concentrate (EC50) liquid formulation

The figure is taken from Wikimedia under a Commons agreement.

Table 2. Patient outcomes.

	Phenthoate (n = 292)
Male	218 (74.6%)
Age (years)*	30 (23–42)
Time to admission (hours)*	3.9 (2.4–6.8)
Glasgow Coma Score at admission*	15 (14–15)
Direct admissions	184 (63%)
Transfers from other hospitals	108 (37%)
Pre-hospital treatment
Forced emesis	7 (2.4%)
Gastric lavage	32 (10.9%)
Pralidoxime treatment	26 (8.9%)
In hospital activated charcoal treatment
None	140 (47.9%)
Single dose	122 (41.8%)
Multiple doses	26 (8.9%)
Outcomes
Number of patients who survived without intubation	245 (83.9%)
Number of patients intubated and survived	26 (8.9%)
Number of deaths	19 (6.5%)
Number of patients requiring intubation	42 (14.4%)
Number of patients with seizures	2 (0.7%)
Admission GCS for fatal cases *	11 (3 to 15)

Data are numbers (%) or * median (IQR). Time of ingestion was known for 279 patients. One patient was intubated and transferred to another hospital, so their discharge status is not known. Data about activated charcoal treatment was known for 288 patients.

Figure 1. Box violin plots showing distribution of patients’ time from ingestion to first intubation in graph A (n = 37), duration of ventilation in graph B (n = 41), and time to death from ingestion in graph C (n = 19).

Figure 2. Relationship between time since poisoning and initial plasma phenthoate concentration (ng/ml) for 59 patients. Three outliers [(106, 17), (1.6, 2601) and (1.5, 5257)] are represented with arrows. Patients present with variable amounts of phenthoate concentration in their blood, with an apparent trend towards lower phenthoate concentrations in late presentations.

Figure 3. AChE and BuChE activity in 8 patients. Red symbols represent patients receiving pralidoxime. Blue symbols represent patients receiving placebo. Each symbol shape represents a different patient. The graph shows a modest increase in cholinesterase activity in the first hour among 5 out of 6 patients who received pralidoxime.