Amitraz Poisoning
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T60.9 *Notifiable condition. DESCRIPTION Amitraz is pesticide used in tick-dips for animals and as an insecticide in crop sprays. Liquid formulations often contain solvents that may cause additional clinical effects. Significant skin contact may lead to systemic effects. Note : Where th
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
ICD-10 code: T60.9
*Notifiable condition.
DESCRIPTION
Amitraz is pesticide used in tick-dips for animals and as an insecticide in crop sprays. Liquid formulations often contain solvents that may cause additional clinical effects. Significant skin contact may lead to systemic effects.
Note:
Where the history is of an unspecified rat poison or pesticide ingestion, consider other active ingredients such as ‘super-warfarin’ anticoagulants and organophosphates.
DIAGNOSTIC CRITERIA
Clinical
Symptoms occur between 30 minutes to 4 hours.
- Gastrointestinal: vomiting.
- Central nervous system: ataxia, drowsiness (leading to coma), seizures. No excessive secretions. Pinpoint pupils or dilated pupils may be present.
- Cardiovascular: bradycardia, hypotension (or hypertension).
- Respiratory depression, or tachypnoea, aspiration and chemical pneumonitis.
- Hypothermia and hyperglycaemia are common.
Amitraz poisoning can be confused with organophosphate poisoning, but it does not cause excessive sweating and salivation, urinary and faecal incontinence or muscle fasciculation which are seen with organophosphate poisoning. Furthermore, organophosphate toxicity results in reduced serum pseudocholinesterase levels.
Investigations
- Acidosis (respiratory or metabolic).
- Liver enzymes.
- Chest X-ray, if respiratory symptoms.
GENERAL AND SUPPORTIVE MEASURES
- Decontaminate skin and clothes if applicable.
- Monitoring (blood pressure, pulse, respiration, level of consciousness, temperature, blood gas, blood sugar).
- Asymptomatic: observe for 4 hours.
- Symptomatic: supportive treatment as required.
MEDICINE TREATMENT
- Activated charcoal, See: Poisoning, treatment.
Specific treatment should only be used if there is inadequate response to standard resuscitation measures.
- Atropine may be used for severe bradycardia.
REFERRAL
- Severe cases requiring intensive care.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 18: Poisoning, 18.1 Poisoning, 18.1.19 Amitraz Poisoning