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VOLUME 16 , ISSUE 1 ( January, 2012 ) > List of Articles

CASE REPORT

Cartap hydrochloride poisoning: A clinical experience

Hari K. Boorugu, Anugrah Chrispal

Keywords : Cartap hydrochloride, nereistoxin, respiratory depression

Citation Information : Boorugu HK, Chrispal A. Cartap hydrochloride poisoning: A clinical experience. Indian J Crit Care Med 2012; 16 (1):58-59.

DOI: 10.4103/0972-5229.94443

License: CC BY-ND 3.0

Published Online: 00-01-2012

Copyright Statement:  Copyright © 2012; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Cartap hydrochloride, a nereistoxin analog, is a commonly used low toxicity insecticide. We describe a patient who presented to the emergency department with alleged history of ingestion of Cartap hydrochloride as an act of deliberate self-harm. The patient was managed conservatively. To our knowledge this is the first case report of Cartap hydrochloride suicidal poisoning. Cartap toxicity has been considered to be minimal, but a number of animal models have shown significant neuromuscular toxicity resulting in respiratory failure. It is hypothesized that the primary effect of Cartap hydrochloride is through inhibition of the [3 H]-ryanodine binding to the Ca 2+ release channel in the sarcoplasmic reticulum in a dose-dependent manner and promotion of extracellular Ca 2+ influx and induction of internal Ca 2+ release. This results in tonic diaphragmatic contraction rather than paralysis. This is the basis of the clinical presentation of acute Cartap poisoning as well as the treatment with chelators namely British Anti Lewisite and sodium dimercaptopropane sulfonate.


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  1. Effects of cartap on isolated mouse phrenic nerve diaphragm and its related mechanism. Toxicol Sci 2000;55:453-9.
  2. Susceptibility to cartap-induced lethal effect and diaphragmatic injury via ocular exposure in rabbits. Toxicology 2003;5;192:139-48.
  3. [Antidotal effects of sulfhydryl compounds on acute poisonings by sodium ammonium dimethyl-2-(propane-1,3-dithiosulfate) monohydrate, nereistoxin and cartap]. Zhongguo Yao Li Xue Bao 1990;11:180-4.
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