a-Naphthyl-thiourea (ANTU) is a moderately toxic rodenticide. It is very selective for target species, with humans being relatively resistant. This compound is a fine, blue-gray powder that is odorless, water-insoluble, and slightly bitter. The mechanism of action is unknown, but this toxin does appear to increase alveolar capillary permeability, causing pulmonary edema. Patients present clinically with dyspnea, cough, pleuritic chest pain, noncardiogenic pulmonary edema, and pleural effusion. Treatment is supportive and includes activated charcoal and catharsis.
Cholecalciferol (vitamin D3) is used widely by professional exterminators and the general public. This compound is marketed as Quintox, Rampage, or Ortho Mouse-B-Gon. In rodents, toxic doses result in the mobilization of calcium from bones, producing hypercalcemia, osteomalacia, and systemic metastatic calcifications. No severe human toxicity or deaths have been reported. Small amounts are probably nontoxic and do not require therapy.
Signs and symptoms are those associated with vitamin D intoxication and hypercalcemia. Clinically, patients present with nausea, vomiting, abdominal pain, constipation, and CNS depression. Nerve and muscle dysfunction and dysrhythmias may be seen. Serum calcium, magnesium and electrolyte levels should be monitored. Normal levels obtained 48 h after acute ingestion probably exclude significant toxicity. Therapy after acute massive ingestion includes activated charcoal and sorbitol. Treatment of moderate to severe hypercalcemia involves intravenous infusion of normal saline, furosemide, steroids, and calcitonin (see Cha.p.;.23).
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