PRINCIPLES OF TOXICOLOGY

thallium sulfate–induced encephalopathy. Death from thallium sulfate intoxication is due to respiratory
paralysis or cardiovascular failure.
Serum, urine, and hair thallium levels can be used to assess exposure to this compound. There is
no specific treatment for thallium sulfate poisoning, and treatment is supportive. Syrup of ipecac and
activated charcoal can be used to decrease gastrointestinal absorption.
Sodium Fluoroacetate
Sodium fluoroacetate is also known as 1080 (registered trademark). This compound is easily absorbed
via ingestion as well as through inhalation and dermal routes. The toxicity of sodium fluoroacetate is
due to the reaction of three molecules of fluoroacetate which form fluorocitrate in the liver. Fluorocitrate
adversely affects cellular respiration through disruption of the tricarboxylic acid cycle (inhibiting
the enzyme cis-aconitase). It is thought that the accumulation of citrate in tissues also accounts for
some of the acute toxicity associated with this compound. The target organs of sodium fluoroacetate
are the heart (seen as arrhythmias leading to ventricular fibrillation) and the brain (manifested as
convulsions and spasms), following intoxication (typically following suicidal or accidental ingestion).
A specific antidote to sodium fluoroacetate intoxication does not exist. Treatment consists of decontamination
and supportive therapy, including gastric lavage and catharsis.
15.7 FUMIGANTS
The fumigants (e.g., see Figure 15.9) are a group of compounds that are volatile in nature. Some of
the fumigants exist in a gas phase at room temperature while others are liquids or solids.
Fumigants are in general readily absorbed via dermal, respiratory, and ingestion routes. Treatment
for overexposure to fumigants typically includes irrigation of the contaminated areas (skin, eyes).
Following irrigation of eyes, medical treatment should be sought because some of these compounds
are severely corrosive to the cornea. Sufficient dermal absorption may occur as to produce systemic
effects. Patients with inhalation exposure should be monitored for pulmonary edema and treated
accordingly if edema develops. Contaminated clothing should be removed and discarded. It should be
Figure 15.9 Chemical structures of selected fumigants.
15.7 FUMIGANTS 361