DISODIUMPHOSPHATE-Pesticide：磷酸二钠-农药.doc

Hazardous Substances Data Bank, National Library of Medicine, Bethesda, MD./Downloaded September, 2004DISODIUM PHOSPHATECASRN: 7558-79-4For other data, click on the Table of ContentsHuman Health Effects:Human Toxicity Excerpts: ANHYDROUS FORM MAY CAUSE MILD IRRITATION TO SKIN, MUCOUS MEMBRANES; INTERNALLY CAUSES PURGING. Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1366*PEER REVIEWED*TOXICITY OF PARENTERAL . /DIBASIC & MONOBASIC SODIUM PHOSPHATE/ IS DUE TO THEIR SEQUESTRATION OF CALCIUM. . SYSTEMIC REACTIONS ARE UNLIKELY WHEN THESE SALTS /DIBASIC & MONOBASIC SODIUM PHOSPHATE/ ARE GIVEN BY MOUTH. Gosselin, R.E., R.P. Smith, H.C. Hodge. Clinical Toxicology of Commercial Products. 5th ed. Baltimore: Williams and Wilkins, 1984.,p. II-120*PEER REVIEWED*ACUTE . EYE CONTACT WITH CONCENTRATED ALKALI CAUSES CONJUNCTIVAL EDEMA & CORNEAL DESTRUCTION. ALKALIES PENETRATE SKIN SLOWLY. EXTENT OF DAMAGE THEREFORE DEPENDS ON DURATION OF CONTACT. CHRONIC POISONING (FROM SKIN CONTACT). CHRONIC DERMATITIS MAY FOLLOW REPEATED CONTACT . /ALKALIES/ Dreisbach, R. H. Handbook of Poisoning. 9th ed. Los Altos, California: Lange Medical Publications, 1977. 202*PEER REVIEWED*ACUTE POISONING BY INJESTION: . EVEN THOUGH PATIENTS RECOVER FROM IMMEDIATE DAMAGE, ESOPHAGEAL STRICTURE CAN OCCUR WK, MO, OR YR LATER TO MAKE SWALLOWING DIFFICULT. INGESTION OF TRIPOLYPHOSPHATE . IN . DETERGENTS OR LAXATIVES CAUSE SHOCK-LIKE STATE, FALL OF BLOOD PRESSURE, SLOW PULSE, CYANOSIS COMA & SOMETIMES TETANY AS RESULT OF REDN IN IONIC CALCIUM. /ALKALIES/ Dreisbach, R.H. Handbook of Poisoning. 12th ed. Norwalk, CT: Appleton and Lange, 1987. 211*PEER REVIEWED*Sodium and potassium hexametaphosphates, polyphosphates, tripolyphosphates, pyrophosphates, and other phosphates used as water softeners form complexes with calcium and, after ingestion, are capable of seriously reducing the serum level of ionic calcium. They have less corrosive effect on mucous membranes than sodium or potassium hydroxide. Hydrolysis of the polymeric phosphates can also produce acidosis. /Alkalies & phosphates/ Dreisbach, R.H. Handbook of Poisoning. 12th ed. Norwalk, CT: Appleton and Lange, 1987. 211*PEER REVIEWED*The estimated fatal dose of sodium phosphates is 50 g. The corrosive effect is strong irritation & erythema, blistering. /Alkalies & phosphates; from table/ Dreisbach, R.H. Handbook of Poisoning. 12th ed. Norwalk, CT: Appleton and Lange, 1987. 212*PEER REVIEWED*Skin, Eye and Respiratory Irritations: Dust: Irritating to eyes, nose and throat. If inhaled will cause coughing or difficult breathing. Solid: Irritating to skin and eyes. U.S. Coast Guard, Department of Transportation. CHRIS - Hazardous Chemical Data. Volume II. Washington, D.C.: U.S. Government Printing Office, 1984-5.*PEER REVIEWED*Drug Warnings: THIS PHOSPHATE SHOULD NOT BE CONFUSED WITH TRIBASIC SODIUM PHOSPHATE WHICH IS VERY ALKALINE & HAS CAUSTIC ACTION. Osol, A. (ed.). Remingtons Pharmaceutical Sciences. 16th ed. Easton, Pennsylvania: Mack Publishing Co., 1980. 745*PEER REVIEWED*Oral administration is safer, but careful monitoring of serum electrolyte levels and renal function is necessary. Nausea, vomiting, and diarrhea may occur and may be dose dependent. Concomitant use of antacids containing aluminum and/or magnesium should be avoided, because they may bind phosphate and prevent it absorption (calcium antacids also may bind phosphate, and it is assumed that these agents are not given to hypercalcemic patients). /Monobasic or dibasic sodium or potassium phosphate/ American Medical Association, Department of Drugs. Drug Evaluations. 6th ed. Chicago, Ill: American Medical Association, 1986. 897*PEER REVIEWED*Phosphate should not be given to patients with impaired renal function or hyperphosphatemia. They should not be given to patients with alkaline urine due to urinary tract infections because increased calcium and phosphate concentrations in the alkaline urine increase the risk of calcium phosphate stones. /Monobasic or dibasic sodium or potassium phosphate/ American Medical Association, Department of Drugs. Drug Evaluations. 6th ed. Chicago, Ill: American Medical Association, 1986. 897*PEER REVIEWED*Medical Surveillance: In total parenteral nutrition . potassium or sodium phosphate is essential; requirements for phosphate are increased when glycolytic activity is increased or urinary losses are high (eg, persistent acidosis proximal renal tubular defect). For /adults/ approximately 200 to 400 mg (6.5 to 13 mM) of phosphorus is required daily for maintenance, but larger amounts are often needed when initiating total parenteral nutrition to maintain the serum phosphate level above 2.5 mg/dl. For each 500 ml of 50% dextrose in water infused, 12 mM of phosphorus has been recommended. American Medical Association, Department of Drugs. Drug Evaluations. 6th ed. Chicago, Ill: American Medical Association, 1986. 864*PEER REVIEWED*Emergency Medical Treatment: EMT Copyright Disclaimer:Portions of the POISINDEX(R) and MEDITEXT(R) database have been provided here for general reference. THE COMPLETE POISINDEX(R) DATABASE OR MEDITEXT(R) DATABASE SHOULD BE CONSULTED FOR ASSISTANCE IN THE DIAGNOSIS OR TREATMENT OF SPECIFIC CASES. The use of the POISINDEX(R) and MEDITEXT(R) databases is at your sole risk. The POISINDEX(R) and MEDITEXT(R) databases are provided AS IS and as available for use, without warranties of any kind, either expressed or implied. Micromedex makes no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the POISINDEX(R) and MEDITEXT(R) databases. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Micromedex does not assume any responsibility or risk for your use of the POISINDEX(R) or MEDITEXT(R) databases. Copyright 1974-2004 Thomson MICROMEDEX. All Rights Reserved. Any duplication, replication, downloading, sale, redistribution or other use for commercial purposes is a violation of Micromedex rights and is strictly prohibited.The following Overview, * INORGANIC PHOSPHATES *, is relevant for this HSDB record chemical.Life Support: o This overview assumes that basic life support measures have been instituted.Clinical Effects: 0.2.1 SUMMARY OF EXPOSURE ACUTE EXPOSURE A) The most frequently seen effect following ingestion or rectal administration is gastrointestinal irritation. If a significant amount of phosphate is absorbed, hyperphosphatemia, hypocalcemia and hypomagnesemia may occur. B) Fluid and electrolyte abnormalities have been reported following exposure by oral, rectal, and intravenous routes. C) Severe hyperphosphatemia and hypocalcemia may result in tetany, seizures, bradycardia, prolonged QT interval, dysrhythmias, coma, and cardiac arrest. Severe dehydration, hypernatremia, hypotension, metabolic acidosis and tachycardia may also develop. D) The elderly, young children and patients with renal insufficiency are at increased risk of toxicity. 0.2.3 VITAL SIGNS 0.2.5 CARDIOVASCULAR ACUTE EXPOSURE A) Tachycardia, bradycardia, heart block, EKG changes, and cardiac arrest have been reported secondary to electrolyte abnormalities. B) Excessive absorption of sodium may aggravate congestive heart failure. C) Hypotension secondary to dehydration may occur. 0.2.6 RESPIRATORY ACUTE EXPOSURE A) Hyperventilation may occur secondary to hypocalcemia. 0.2.7 NEUROLOGIC ACUTE EXPOSURE A) Coma, seizures, and tetany have been reported secondary to electrolyte abnormalities. 0.2.8 GASTROINTESTINAL ACUTE EXPOSURE A) Nausea, vomiting, abdominal pain, and diarrhea are common, leading to dehydration. 0.2.10 GENITOURINARY ACUTE EXPOSURE A) A mild diuresis may be noted following excessive absorption of these compounds. B) Acute renal failure in association with electrolyte imbalances was reported following therapeutic oral administration of a phosphosoda solution. 0.2.11 ACID-BASE ACUTE EXPOSURE A) Metabolic acidosis is a frequent occurrence following administration of hypertonic phosphate enema solutions. 0.2.12 FLUID-ELECTROLYTE ACUTE EXPOSURE A) Hyperphosphatemia, hypocalcemia, and tetany have occurred following overdosage with a phosphate-containing laxative and following recommended doses in patients with renal insufficiency. B) Fluid and electrolyte abnormalities (dehydration and hypokalemia) may be noted secondary to excessive diarrhea. 0.2.15 MUSCULOSKELETAL ACUTE EXPOSURE A) Carpopedal spasm is a common presenting sign in inorganic phosphate poisoning and associated hypocalcemia. 0.2.20 REPRODUCTIVE HAZARDS A) At the time of this review, no data were available to assess the potential effects of exposure to this agent during pregnancy or lactation.Laboratory: A) Monitor fluid and electrolyte status, including serum phosphate, calcium, potassium, sodium and magnesium concentrations. B) Obtain an ECG and institute continuous cardiac monitoring.Treatment Overview: 0.4.2 ORAL EXPOSURE A) EMESIS: Ipecac-induced emesis is not recommended because of the potential for CNS depression, seizures and cardiovascular instability. B) GASTRIC LAVAGE: Consider after ingestion of a potentially life-threatening amount of poison if it can be performed soon after ingestion (generally within 1 hour). Protect airway by placement in Trendelenburg and left lateral decubitus position or by endotracheal intubation. Control any seizures first. 1) CONTRAINDICATIONS: Loss of airway protective reflexes or decreased level of consciousness in unintubated patients; following ingestion of corrosives; hydrocarbons (high aspiration potential); patients at risk of hemorrhage or gastrointestinal perforation; and trivial or non-toxic ingestion. C) Hydrate with 0.9% of 0.45% saline as clinically indicated. Correct hypocalcemia, hypomagnesemia, hypernatremia, and hyper or hypokalemia. Monitor urine output. D) CONGESTIVE HEART FAILURE patients with an excessive sodium load and normal renal function may be managed with a diuretic such as furosemide (1 mg/kg IV to a maximum of 40 mg). E) SEIZURES: Administer a benzodiazepine IV; DIAZEPAM (ADULT: 5 to 10 mg, repeat every 10 to 15 min as needed. CHILD: 0.2 to 0.5 mg/kg, repeat every 5 min as needed) or LORAZEPAM (ADULT: 2 to 4 mg; CHILD: 0.05 to 0.1 mg/kg). 1) Consider phenobarbital if seizures recur after diazepam 30 mg (adults) or 10 mg (children 5 years). 2) Monitor for hypotension, dysrhythmias, respiratory depression, and need for endotracheal intubation. Evaluate for hypoglycemia, electrolyte disturbances, hypoxia. F) HYPOTENSION: Infuse 10 to 20 mL/kg isotonic fluid. If hypotension persists, administer dopamine (5 to 20 mcg/kg/min) or norepinephrine (ADULT: begin infusion at 0.5 to 1 mcg/min; CHILD: begin infusion at 0.1 mcg/kg/min); titrate to desired response. G) ATROPINE: ADULT DOSE: BRADYCARDIA: 0.5 to 1 mg IV every 5 min. ASYSTOLE: 1 mg IV every 5 min. Maximum total dose 3 mg or 0.04 mg/kg. Minimum single dose 0.5 mg. PEDIATRIC DOSE: 0.02 mg/kg IV repeat every 5 min, minimum single dose 0.1 mg; maximum single dose child 0.5 mg, adolescent 1 mg; maximum total dose 1 mg child, 2 mg adolescent. H) Hemodialysis may be necessary to rapidly correct hyperphosphatemia and hypocalcemia in severe cases. 0.4.3 INHALATION EXPOSURE A) INHALATION: Move patient to fresh air. Monitor for respiratory distress. If cough or difficulty breathing develops, evaluate for respiratory tract irritation, bronchitis, or pneumonitis. Administer oxygen and assist ventilation as required. Treat bronchospasm with inhaled beta2 agonist and oral or parenteral corticosteroids. 0.4.4 EYE EXPOSURE A) DECONTAMINATION: Irrigate exposed eyes with copious amounts of room temperature water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist, the patient should be seen in a health care facility. 0.4.5 DERMAL EXPOSURE A) OVERVIEW 1) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water. A physician may need to examine the area if irritation or pain persists.Range of Toxicity: A) Hyperphosphatemia, hypocalcemia, and hyperosmolarity developed in a 10 kg toddler following ingestion of 60 mL of a buffered sodium biphosphate and sodium phosphate solution. B) A premature infant developed hyperphosphatemia, and subsequently died, after inadvertently receiving 341 mg of sodium phosphate.Rumack BH POISINDEX(R) Information System Micromedex, Inc., Englewood, CO, 2004; CCIS Volume 122, edition expires Nov, 2004. Hall AH & Rumack BH (Eds): TOMES(R) Information System Micromedex, Inc., Englewood, CO, 2004; CCIS Volume 122, edition expires Nov, 2004.*PEER REVIEWED*Antidote and Emergency Treatment: Basic treatment: Establish a patent airway. Suction if necessary. Watch for signs of respiratory insufficiency and assist respirations if needed. Administer oxygen by nonrebreather mask at 10 to 15 L/min. Monitor for pulmonary edema and treat if necessary . . Monitor for shock and treat if necessary . . For eye contamination, flush eyes immediately with water. Irrigate each eye continuously with normal saline during transport . . Do not use emetics. Activated charcoal is not effective. For ingestion, rinse mouth and administer 5 mL/kg up to 200 mL of water for dilution if the patient can swallow, has a strong gag reflex, and does not drool . . Do not attempt to neutralize because of exothermic reaction. Cover skin burns with dry, sterile dressings after decontamination . . /Inorganic Acids and Related Compounds/ Bronstein, A.C., P.L. Currance; Emergency Care for Hazardous Materials Exposure. 2nd ed. St. Louis, MO. Mosby Lifeline. 1994. 149*PEER REVIEWED*Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious or in respiratory arrest. Early intubation, at the first signs of upper airway obstruction, may be necessary. Positive-pressure ventilation techniques with a bag-valve-mask device may be beneficial. Monitor cardiac rhythm and treat arrhythmias as necessary . . Start an IV of D5W TKO /SRP: To keep open, minimal flow rate/. Use lactated Ringers if signs of hypovolemia are present. Watch for signs of pulmonary edema. For hypotension with signs of hypovolemia, administer fluid cautiously. Watch for signs of fluid overload. Consider drug therapy for pulmonary edema . . For hypotension with signs of hypovolemia, administer fluid cautiously. Consider vasopressors if patient is hypotensive with a normal fluid volume. Watch for signs of fluid overload . . Use proparacaine hydrochloride to assist eye irrigation . . /Inorganic Acids and Related compounds/ Bronstein, A.C., P.L. Currance; Emergency Care for Hazardous Materials Exposure. 2nd ed. St. Louis, MO. Mosby Lifeline. 1994. 149*PEER REVIEWED*Animal Toxicity Studies:Non-Human Toxicity Excerpts: DISODIUM PHOSPHATE GIVEN INTRACEREBROVENTRICULARLY (ICV) IN RATS ELICITED A SYNDROME CHARACTERIZED BY BEHAVIORAL & EEG ACTIVATION, STEREOTYPES, HYPERRESPONSIVENESS, & ANALGESIA. LABELLA F ET AL; DEV NEUROSCI (AMSTERDAM) 4 (CHARACT FUNCT OPIOIDS): 361-2 (1978)*PEER REVIEWED*Tested on rabbit eyes by continuous exposure for three hours as 0.1 M solution at pH 7.0 to 7.5 made up to 0.46 osmolar with sodium chloride or sucrose, caused no disturbance of the cornea. Clayton, G.D., F.E. Clayton (eds.) Pattys Industrial Hygiene and Toxicology. Volumes 2A, 2B, 2C, 2D, 2E, 2F: Toxicology. 4th ed. New York, NY: John Wiley & Sons Inc., 1993-1994. 841*PEER REVIEWED*Non-Human Toxicity Values: LD50 Rat oral 17 g/kg Lewis, R.J. Saxs Dangerous Properties of Industrial Materials. 9th ed. Volumes 1-3. New York, NY: Van Nostrand Reinhold, 1996. 2989*PEER REVIEWED*Metabolism/Pharmacokinetics:Metabolism/Metabolites: In the body, phosphorus is converted to phosphates. /Phosphorus/ Clayton, G. D. and F. E. Clayton (eds.). Pattys Industrial Hygiene and Toxicology: Volume 2A, 2B, 2C: Toxicology. 3rd ed. New York: John Wiley Sons, 1981-1982. 2122*PEER REVIEWED*Absorption, Distribution & Excretion: . PHOSPHATES (DIBASIC & MONOBASIC SODIUM PHOSPHATE) ARE SLOWLY & INCOMPLETELY ABSORBED. /DIBASIC & MONOBASIC SODIUM PHOSPHATE/ Gosselin, R.E., H.C. Hodge, R.P. Smith, and M.N. Gleason. Clinical Toxicology of Commercial Products. 4th ed. Baltimore: Williams and Wilkins, 1976.,p. II-83*PEER REVIEWED*Net phosphorus absorption may occur in the small intestine in s