Agent orange
Background
- Member of chlorophenoxy pesticide group, and are often contaminated with dioxin
- Gained notoriety during Vietnam War
Mechanism
- Absorbed through skin, GI tract, and respiratory tract
- Acts on skeletal muscle but exact mechanism unknown
Clinical Features
- Serious toxic effects develop in 4-6 hours
- Non-specific dermal and GI irritation (nausea, vomiting, GI distress)
- Myotonia, muscle fasciculations, rhabdomyolysis, hyperthermia
Differential Diagnosis
Chemical weapons
- Blister chemical agents (Vesicants)
- Lewisite (L)
- Sulfur mustard (H)
- Phosgene oxime (CX)
- Pulmonary chemical agents (Choking agents)
- Incendiary agents
- Cyanide chemical weapon agents (Blood agents)
- Prussic acid (AKA hydrogen cyanide, hydrocyanic acid, or formonitrile)
- Nerve Agents (organophosphates)
- Acetylcholinesterase inhibitors
- Household and commercial pesticides (diazinon and parathion)
- G-series (sarin, tabun, soman)
- V-series (VX)
- Lacrimating or riot-control agents
- Pepper spray
- Chloroacetophenone
- CS
Evaluation
- No specific tests for chlorophenoxy compounds
- Workup is aimed at detecting muscle injury and hepatic/renal function
Management
- Skin decontamination
- Supportive care
- Treat rhabdomyolysis, hyperthermia, and metabolic acidosis
Disposition
See Also
References
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