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Human & Experimental Toxicology
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Repeated measurements of aldicarb in blood and urine in a case of nonfatal poisoning

A Tracqui

Institut de Médecine Légale, Faculté de Médecine de Strasbourg, 11 rue Humann, 67085 Strasbourg Cedex, France

F Flesch

P Sauder

Service de Réanimation Médicale et Centre Anti-Poisons, Pavillon Pasteur, CHRU/Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg Cedex, France

J S Raul

A Géraut

B Ludes

Institut de Médecine Légale, Faculté de Médecine de Strasbourg, 11 rue Humann, 67085 Strasbourg Cedex, France

A Jaeger

Service de Réanimation Médicale et des Urgences Médicales, Hôpital de Hautepierre, CHRU/Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg Cedex, France

A nonfatal case of poisoning involving aldicarb, an extremely toxic carbamate pesticide, is presented. A 39-year-old female ingested an unknown amount of aldicarb, together with alprazolam and sertraline. On admission to ICU (T0), she displayed marked cholinergic symptoms and a deep coma. The patient was given pralidoxime and atropine. Her condition gradually improved on days 2 and 3 and she was discharged at T0+80 h. Aldicarb was assayed by high-performance liquid chromatography on 21 blood and 8 urine samples successively taken during hospitalization. At the same time, serum pseudocholinesterase activity was followed on 21 successive samples. Blood aldicarb level was 3.11 g/mL at T0 and peaked at T0+3.5 h (3.22 g/mL), then followed a two-slope decay with a terminal half-life of ca. 20 h. Aldicarb was detected in all urine samples (peak level: 6.95 g/mL at T0+31.5 h) and was still present at the time of discharge. Serum pseudo-cholinesterase activity remained low (10% of normal) until the 30th hour then rapidly increased and returned to normal after the 60th hour. The patient’s clinical picture closely followed blood aldicarb levels and serum pseudo-cholinesterase activities. To our knowledge, this is the first report of an aldicarb poisoning documented by repeated measurements of the drug in the intoxicated person. Human & Experimental Toxicology (2001) 20, 657–660.

Key Words: aldicarb • arbamate • poisoning • toxicokinetics • HPLC

Human & Experimental Toxicology, Vol. 20, No. 12, 657-660 (2001)
DOI: 10.1191/096032701718890612
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