Neonicotinoids are a class of insecticides considered less toxic to humans than organophosphates, carbamates, organochloride and pyrethroids. The purpose of this chapter was to systematize existing data in the literature on acute intoxication with neonicotinoids to help practitioners. Clinical manifestations vary across different human systems. Gastrointestinal symptoms consist of nausea, vomiting, abdominal pain and corrosive lesions. In the central nervous system, headaches, agitation, confusion, fasciculations, seizures or coma may occur, while tachycardia or bradycardia, hypertension, hypotension and palpitations occur in the cardiovascular system. Respiratory effects are dyspnea, aspiration pneumonia or respiratory failure. Solvents that drive the insecticide also have an important role in the toxic effects. There are no specific biological tests of neonicotinoid intoxication, and their dosing is not routinely available. Treatment is symptomatic. Mortality is less than 3%, well below the poisoning with anticholinesterase insecticides, like organophosphates and carbamates.
Part of the book: Poisoning
Poisonings during childhood (both accidental and voluntary) are a common cause of presentation in the emergency departments (EDs) and the pediatric intensive care unit (PICU). The admission to PICU is warranted both for treatment and for continuous monitoring, as sometimes the evolution of a poisoning could be unpredictable. Sometimes, complications arise that may prolong the patients’ hospitalization and may contribute to lowering the survival rate. The staff in these departments must be well trained to ensure patient monitoring, early detection of complications, and rapid intervention. Supporting vital functions is the main objective of the management of a poisoned patient admitted in PICU. In recent years, staff competence and advanced medical technology have helped to improve the prognosis of the patients admitted to these departments, including of the poisoned patients.
Part of the book: Poisoning in the Modern World