Ngé ®éc
paraquat-diquat
PARAQUAT:
PARAQUAT:
!! "#$%
!! "#$% &
"#$%'(%("&
) (*("+&
"#$%'(%("&
)),)#)#(&
)),)#(&
%("&
-./0120.34563
$7.89:6;-<=>
$7.89:6;-<=>
>?>@A@0B.6BC>D$EF&
>?>@A@0B.6BC>D$EF&
$7$E.8C5>GH1B..<
$7$E.8C5>GH1B..<
.I.JK&
.I.JK&
L9GMEN0O>P
L9GMEN0O>P
G&
G&
+BQD.91BC5RQQF5
+BQD.91BC5RQQF5
-0$.?H0C-K
-0$.?H0C-K
EN0O>.>?S?Q&
EN0O>.>?S?Q&
EN0O>0T@K-L6UC8=V
EN0O>0T@K-L6UC8=V
6UUQC&
6UUQC&
J9W>U X
J9W>U X
Paraquat:
Paraquat:
.>?S?QQG3QS.?*
.>?S?QQG3QS.?*
QS.?Q$Q.@S?$Q.@?S?QCC.S?Q
QS.?Q$Q.@S?$Q.@?S?QCC.S?Q
CC.3#?C#?SQ.?C63
CC.3#?C#?SQ.?C63
QS.?+YQQ045ZQQ6?C&
QS.?+YQQ045ZQQ6?C&
Paraquat + diquat:
Paraquat + diquat:
.>?S?QQS.)?.
.>?S?QQS.)?.
$Q.@S?.QC?Q.C?Q45ZQQ6?C&
$Q.@S?.QC?Q.C?Q45ZQQ6?C&
Paraquat + triazine:
Paraquat + triazine:
#Q GCQQCQ.
#Q GCQQCQ.
Gramoxone
Gramoxone
:
:
+N0O>0.3
+N0O>0.3
9:[0
9:[0
Gramoxone
.39\@?? =[V>C]9L “ ”
.39\@?? =[V>C]9L “ ”
4>H.9:=@^@-?UG45?-&
4>H.9:=@^@-?UG45?-&
“
“
)?5 G=@00@N?41G”
)?5 G=@00@N?41G”
E26_&
E26_&
Thùc tÕ:
Thùc tÕ:
#UC165.?-!`a>DbcFS1>
#UC165.?-!`a>DbcFS1>
A045?9d>69C\.?1B.&
A045?9d>69C\.?1B.&
#K0S/36C16T9We26f<
#K0S/36C16T9We26f<
<
<
→
→
24?&
24?&
.363-<>U4?51
.363-<>U4?51
X24?&
X24?&
^->UKE26_U!`9&
^->UKE26_U!`9&
.3-<[-40T9\@K
.3-<[-40T9\@K
K63<4A&
K63<4A&
%X<
%X<
b<%ghD<4AF!gh>7Gi&
b<%ghD<4AF!gh>7Gi&
#eKL9:ijhh>7Gd924?
#eKL9:ijhh>7Gd924?
!hhk
!hhk
→
→
<&
<&
9:Ci!_>66jhkD!hjh>CF24?&
9:Ci!_>66jhkD!hjh>CF24?&
3l<W0.3CX24?9:Cm
3l<W0.3CX24?9:Cm
!jD`hmh>C66jhkF&
!jD`hmh>C66jhkF&
Các nỗ lực làm giảm tỷ lệ tử vong:
Các nỗ lực làm giảm tỷ lệ tử vong:
Hầu nh tất cả các trờng hợp ngộ độc paraquat đ
Hầu nh tất cả các trờng hợp ngộ độc paraquat đ
ờng uống, loại dd 20% đều đợc nhìn nhận là có thể
ờng uống, loại dd 20% đều đợc nhìn nhận là có thể
tử vong.
tử vong.
N><AN!hhh24?7a>
N><AN!hhh24?7a>
a>!nom->6;66jhk&Bp6;
a>!nom->6;66jhk&Bp6;
0.363gk&
0.363gk&
b945?6>_->UKE26_D qU
b945?6>_->UKE26_D qU
Kp9:9\5?U?>9\0r06;F&
Kp9:9\5?U?>9\0r06;F&
I>N@?GNa24?&
I>N@?GNa24?&
#J>->5DS6.:F>;iDG=iF
#J>->5DS6.:F>;iDG=iF
-1BHDVHE>F&
-1BHDVHE>F&
b<s
HÊp thu:
HÊp thu:
.363i<-0itBK
.363i<-0itBK
L.<?
L.<?
↑
↑
G7>T9W&
G7>T9W&
.3
.3
GHu40.?Q
GHu40.?Q
$#&
$#&
<p$#t0.3
<p$#t0.3
UjEi&
UjEi&
,67>KGr?656T9WEv&
,67>KGr?656T9WEv&
$H-0U?Uw?G0GH45?E19:
$H-0U?Uw?G0GH45?E19:
H-0GH1B<<&
H-0GH1B<<&
b<s
Ph©n bè:
Ph©n bè:
.301@i=-0TA
.301@i=-0TA
W&
W&
T =Ce40.30K@5?B0Q=
T =Ce40.30K@5?B0Q=
AQ?WKleD)#FGH0_<
AQ?WKleD)#FGH0_<
<&
<&
#Vl01@i!j!m%7G&
#Vl01@i!j!m%7G&
<0.3L0T?10L$#ghCd&
<0.3L0T?10L$#ghCd&
+igx<0.3L0TU>S&
+igx<0.3L0TU>S&
,9=@5?5?EiE=&
,9=@5?5?EiE=&
b<s
ChuyÓn ho¸, th¶i trõ:
ChuyÓn ho¸, th¶i trõ:
b5?Nd9?5?53ABJ
b5?Nd9?5?53ABJ
4y&
4y&
!jjdznhk0.39\NDA
!jjdznhk0.39\NDA
@M9:&
@M9:&
${C{Q!j!jh|<A&=V-B
${C{Q!j!jh|<A&=V-B
.?9V455Bd&
.?9V455Bd&
35?N3A6U65B.<&
35?N3A6U65B.<&
E
.MHSB?G2
.MHSB?G2
Paraquat+Oxy+NADPH
Paraquat+Oxy+NADPH
}Q
}Q
→
→
ie6?
ie6?
•
•
($E0Q.?S6Q
($E0Q.?S6Q
ie6?~?U>5C06t#)0.?Q
ie6?~?U>5C06t#)0.?Q
dKG&
dKG&
UG)$
UG)$
→
→
K#&
K#&
X2>6eQ?WKI06_9
X2>6eQ?WKI06_9
GH5H
GH5H
6QE{Q.?S>QE0Q.?S6Q
6QE{Q.?S>QE0Q.?S6Q
6E>EQC0??0Q.?C454>;4
6E>EQC0??0Q.?C454>;4
@59w@c&
@59w@c&
0B.6BCEa>•9GX>W3lC50T
0B.6BCEa>•9GX>W3lC50T
J?A&
J?A&
BÖnh sinh
ngé ®éc
paraquat
N0€@
TT9WQ?j?U~?U@V>H
TT9WQ?j?U~?U@V>H
0K
0K
→
→
aEBK6d@•TcSW
aEBK6d@•TcSW
SW0TU&
SW0TU&
T@^0;S-BK~?U#0K4J>
T@^0;S-BK~?U#0K4J>
0K1>A0#SW0TN>l5
0K1>A0#SW0TN>l5
.?TGl
.?TGl
↓
↓
KHSB&
KHSB&
?U2.1>V|&
?U2.1>V|&
#A?U2iAdA&
#A?U2iAdA&
%1>E5
$8@dBt90N=
$8@dBt90N=
>J?U-<EN0O>9W>U
>J?U-<EN0O>9W>U
50dG:V>i…
50dG:V>i…
‚>eVOAC9]T9WJ>>U
‚>eVOAC9]T9WJ>>U
>5Eu-H&
>5Eu-H&
6-UƒEK0S/0.3=V
6-UƒEK0S/0.3=V
9UpV>&
9UpV>&
Bn cã 1 trong 3 bÖnh c¶nh l©m sµng
Bn cã 1 trong 3 bÖnh c¶nh l©m sµng
tuú thuéc sè l$îng paraquat BN uèng
tuú thuéc sè l$îng paraquat BN uèng
Ngé ®éc nÆng:
Uèng > 40mg/kg (ngêi 50kg uèng > 2g, >10ml dd 20%)
Uèng > 40mg/kg (ngêi 50kg uèng > 2g, >10ml dd 20%)
+B0tUK.V=&
+B0tUK.V=&
+>@8@?7>C?r>se3N6U65B
+>@8@?7>C?r>se3N6U65B
.<
.<
→
→
4J>NB>.5Gl>5>>50T.
4J>NB>.5Gl>5>>50T.
-&
-&
‚=L?EBH-0K.V&
‚=L?EBH-0K.V&
$?U2iAdAEBA.„EjV4H
$?U2iAdAEBA.„EjV4H
JC9\S-Dngk24?F&
JC9\S-Dngk24?F&
'J>EB?U2489\A&
'J>EB?U2489\A&
S?%-EB>&
S?%-EB>&
$H>J0;I??A*$48I?1I?&
$H>J0;I??A*$48I?1I?&
#aE=cK~N>`6•&
#aE=cK~N>`6•&
$?U2WC.<EB…&
$?U2WC.<EB…&
#24?.?:l@•:i455B9:
#24?.?:l@•:i455B9:
6?Ei>&
6?Ei>&
Ngé ®éc trung b×nh:
Uèng 20- 40mg/kg (ngêi 50kg, uèng 1- 2g, 5-10ml dd 20%)
Uèng 20- 40mg/kg (ngêi 50kg, uèng 1- 2g, 5-10ml dd 20%)
N1>d>W&
N1>d>W&
7>K.V&
7>K.V&
+BH-06d6d0T@M9:455Bd
+BH-06d6d0T@M9:455Bd
E=1>f>>:0TEBH-0&
E=1>f>>:0TEBH-0&
#T9WA[6d.QaG
#T9WA[6d.QaG
9:GH9WSc4a.J&
9:GH9WSc4a.J&
*W0TEX5BKXd&
*W0TEX5BKXd&
bEi24?&
bEi24?&
1<
1<
<0.3>c
<0.3>c
<.@M
<.@M
1<
1<
<0.3>c
<0.3>c
<.@M
<.@M
1<<0.3>c<.@M
1<<0.3>c<.@M
Ngé ®éc nhÑ:
Uèng < 20mg/kg (ngêi 50kg, uèng <1g,
Uèng < 20mg/kg (ngêi 50kg, uèng <1g,
<5ml dd 20%)
<5ml dd 20%)
Ny9:p.cJ
Ny9:p.cJ
?&
?&
$B4s0_?5?5&
$B4s0_?5?5&
Ngé ®éc diquat
#.c9We0.39
#.c9We0.39
GH=.c0TGHSW
GH=.c0TGHSW
0T&
0T&
>S-BK1I?9:
>S-BK1I?9:
[0WDEiC9dBtF
[0WDEiC9dBtF
C¸c H/C LS gîi ý ngé ®éc thuèc
trõ cá nhãm bipyridyl
+BA-0GHC]N9\&
+BA-0GHC]N9\&
*W0Te0?[1>f>3
*W0Te0?[1>f>3
.i0TiScj@JDp=V6?
.i0TiScj@JDp=V6?
0.3F&
0.3F&
+BUGHNl9\&
+BUGHNl9\&
'J>6U65B.<-0
'J>6U65B.<-0
±
±
S-BK#$
S-BK#$
.J
.J
±
±
T9We3N&
T9We3N&
>S-BK1I?&
>S-BK1I?&