Acute Poisoning with Neonicotinoid Insecticide

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