Paraquat, Diquat, Kple Gbewutike Siwo Me Wozãna Le Agbɔsɔsɔme Me: Ðiƒoƒo Kple Belélename Enumake¶

Gbewutike siwo wodzrana le asitsatsa kple agbledede me (gbewutikewo) tso aƒetɔwo ƒe abɔ me atike siwo wotsɔ tsi si me aɖi mele boo o dzi va ɖo dɔwɔƒewo ƒe aɖi siwo gblẽna kabakaba wu eye wowua ame wu le Anyigba dzi la dometɔ aɖewo dzi. Esiawo dometɔ vevitɔe nye Paraquat (1,1'-dimethyl-4,4'-bipyridinium dichloride, si wodzrana le agbledede ƒe ŋkɔwo abe Gramoxone, Parazone, Firestorm, kple Helmquat) kple eƒe atike ƒe ƒometɔ Diquat (si wodzrana le asitsatsa kple tsi me gbewutikewo abe Teƒeɖoɖo, Reglone, kple Tribune alo anyigba ƒe nɔnɔme ƒe atike aɖewo), kpe ɖe agbledede ƒe Glyphosate-Surfactant ƒe tsi siwo wotsɔ ƒo ƒui (abe Roundup Pro / 41% Concentrate) kple Chlorophenoxy gbewutikewo (2,4-D kple Dicamba) ŋu. Ne èmi nu ɖeka (mililita 10 va ɖo 15, alo aɖabaƒoƒo 1) gɔ̃ hã si me paraquat si me tsi le 20% si me wode nu me, alo paraquat xɔxɔ to ŋutigbalẽ si vuvu, si wotso, alo esi me abi le me esime wole akɔtawu sisim le akɔtagbalẽvi me ametakpɔnu manɔmee la, hea ŋɔti kple nuɖuɖutome ƒe dzobibi si gblẽa nu ŋutɔ vɛ, ayiku ƒe ʋukawo ƒe kuku sesẽ, kple free-radical pulmonary fibrosis si meɖea dzi le ame ƒo o si naa ame ƒe lãme ʋãna le ŋkekewo va ɖo kwasiɖa geɖe me.

Ne wò alo ame aɖe si te ɖe ŋuwò mi gbewutike ÐEKA, tsɔ gbewutike si me wodea nuɖuɖui ƒu gbe ɖe ŋkuwo me alo ɖe ŋutigbalẽ dzi, alo no paraquat alo glyphosate si wokɔ ɖe ahanono ƒe aŋetu me le vo me la, ƒo ka na wò nutoa me xexlẽdzesi kpata (911 le United States kple Canada, 112 le Europa Dukɔwo ƒe Habɔbɔ bliboa me, 999 le United Kingdom) to mía tɔ dzi xexlẽdzesi siwo wozãna kpata directory enumake, eye nàto eme aɖi si wotsɔna naa kpekpeɖeŋu gbãtɔ, . atikewo ƒe dzobibi, kple organophosphate nudzodzoeviwutike ƒe aɖi. Elabena aɖabaƒoƒo ɖesiaɖe si wohe ɖe megbe na paraquat te ŋu tsɔa eɖokui dea lãkusi me lãmenugbagbeviwo me vevie, ŋutigbalẽklɔ enumake, atike si noa nu me mimi le aɖabaƒoƒo 60 gbãtɔawo me, kple axe mɔ ɖe oxygen kpeɖeŋutɔ si wozãna edziedzi nu nu vevie negbe ɖe hypoxemia sesẽ aɖe dzɔ hafi nye agbe alo ku ƒe nuwɔna veviwo.

Wɔ esia fifia¶

1. Ƒo ka na 911 / 112 / 999 enumake eye nàxlɔ̃ nu dɔnɔdzikpɔʋua be ate ŋu anye Paraquat: Paraquat kple gbewutike siwo me wodea amii nye atikewɔwɔ kpata vavã siwo xɔa ɣeyiɣi geɖe. Ƒo ka na atikewɔƒe siwo kpɔa nudzɔdzɔ kpatawo gbɔ kple wò nutome Aɖidzikpɔƒe (1-800-222-1222 le U.S.) enumake ale be kɔdzi si xɔe nate ŋu adzra Activated Charcoal (alo Fuller’s Earth / Bentonite) ɖo eye wòaxlɔ̃ nu woƒe nephrology/hemoperfusion kple dɔnɔdzikpɔƒe si kpɔa dɔnɔwo gbɔ vevie hafi nàva.
2. VEVIE NA PARAQUAT: Gblɔ na kpekpeɖeŋunalawo kple ER dɔwɔlawo MEGBE woana oxygen kpeɖeŋutɔ edziedzi o: To vovo na atikewɔwɔ kpata bubu ɖesiaɖe kloe, nana oxygen kpeɖeŋutɔ (O2) na amesi ŋu aɖi le paraquat la wɔa nu abe mɔ̃memi kɔklɔ ɖe dzo dzi ene. Paraquat wua lãkusi me lãmenugbagbeviwo to oxygen molecule zazã tsɔ wɔa superoxide free radicals (O2-). Ele be kpekpeɖeŋunalawo kple dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ kpɔkpɔ ƒe dɔwɔlawo naxe mɔ na oxygen kpeɖeŋutɔ negbe ɖe wowɔ dɔnɔa ƒe ʋu ƒe sisi ƒe oximetry (SpO2) ɖiɖi wu 85 le alafa me va ɖo 88 le alafa me (oxygen ƒe nyaƒoɖeamenu ƒe akpa aɖe PaO2 < 50 mmHg).
3. Ðe awu siwo katã me dɔlékuiwo le eye nàklɔ ŋutigbalẽ kple ŋkuwo hena miniti 15 va ɖo 20: Ne paraquat, diquat, alo glyphosate si me wode tsii ƒu gbe ɖe ŋutigbalẽa dzi alo tsɔe to pantalon alo afɔkpawo me le atike sisi me la, do nitrile alo rababa asigɛ siwo me tsi mate ŋu age ɖo o, ɖe awu siwo katã me dɔlékuiwo le la ɖa, eye nàklɔ ŋutigbalẽa blewuu kple tsi si me wodea tsii kple adzalẽ hena miniti 15 va ɖo 20. MÈGAtsɔ brɔs sesẽ atutu ŋutigbalẽa sesĩe o: ŋutigbalẽa ƒoƒo gbãa mɔxenu si le lãkusia ŋu eye wònana paraquat si wua ame le ɖoɖo nu to ʋukawo me. Tsɔ tsi fafɛ si le sisim klɔ ŋku siwo le tsia dzi la aɖabaƒoƒo 15 va ɖo 20 ya teti.
4. Se "Golden 60-Minute Window" gɔme na nu me babla (Activated Charcoal / Fuller's Earth): Paraquat xɔa kabakaba tso dɔgbo suea me, eye wòɖoa ʋu ƒe agbɔsɔsɔ si de ŋgɔ wu gbɔ le aɖabaƒoƒo 60 va ɖo 120 me, eye le ema megbe la, wotsɔa eƒe dɔwɔwɔ yia lãkusi me le afisi naneke mate ŋu aɖee ɖa o. Dɔnɔa tsɔtsɔ yi xɔ si me wokpɔa dɔnɔwo gbɔ kpata le le aɖabaƒoƒo 60 gbãtɔwo me be woaxɔ Aŋɔ si Wotsɔ Wɔa Dɔe gram 50 va ɖo 100 (alo 15% Fuller ƒe Anyigba / 7% Bentonite anyi afisi wodzrae ɖo) nye afɔɖeɖe ɖeka kolia si wɔa dɔ wu be woatsɔ axe mɔ ɖe ku nu. (De dzesii: Le agbledeƒe didi siwo didi tso atikewɔƒe ɖesiaɖe gbɔ gaƒoƒo geɖe ko la, WHO ƒe agbledziɖoɖowo gblɔ be ne atikewɔwɔ me dzoka xɔxɔ aɖeke meli o la, wozã anyi/bentonite alo anyigba/anyigba dzadzɛ gɔ̃ hã si sɔ na nuɖuɖu le tsi me nana abe agble me binder mamlɛtɔ si ŋu mɔkpɔkpɔ bu ɖo hena paraquat ɖuɖu si ŋu woɖo kpee ene, togbɔ be wolɔ̃a dzoka xɔxɔ si wowɔ le kɔdzi ɣesiaɣi hã).
5. Mègahe ʋuʋudedi vɛ o: Paraquat, diquat, kple glyphosate-surfactant solutions siwo me wode tsii nye atike siwo gblẽa nu le ame ŋu siwo fiãa nu, lãkusi, kple nuɖuɖutome. Ne wozi amea dzi be wòaɖe nu me alo aɖu aɖuɖɔ na gbewutike si gblẽa nu le ame ŋu la gaɖoa nuɖuɖutome zi evelia, si dea afɔku me be nuɖuɖutome nado eye wòage ɖe lãkusia me wòaku.
6. Tsɔ gbewutikea ƒe nugoe vɛ alo nàɖe foto atike si woŋlɔ ɖe edzi tututu: Ðe foto "Active Ingredients" aɖaka kple EPA Registration Number si le zea dzi (ƒo asa na atikeze si le dodom, si me dɔlékui le tsɔtsɔ yi dɔnɔdzikpɔʋu ƒe ʋu me negbe ɖe wotsɔ plastic kpekpewo xee). Le ƒeawo me la, atikewo abe Roundup, Ortho, kple Weedol trɔ nusiwo wɔa dɔ le paraquat, diquat, glyphosate, glufosinate, kple 2,4-D dome.

Nyametsotsoti: Paraquat, diquat, kple gbewutike si me wodea amii ƒe vovototodedeameme¶

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    RouteSplit -->|Oral Ingestion (Intentional OR Accidental Storage in Drink Bottle)| ClassTriage{"Nusiwo Wowɔna Kae Womi?"}

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    ClassTriage -->|3. Concentrated Glyphosate-Surfactant (41% Roundup Pro) or Glufosinate| GlyPath["Caustic + Surfactant Mitochondrial Aɖi:\n1. MÈGADE Ʋuʋudedi Me O; Kpɔ Yaƒoƒomɔ̃ ɖa be Pharyngeal Edema hã le eŋu\n2. IV Lãmetsi Siwo Dzroa Ame Na Hypovolemic/Cardiogenic Shock; Dzra Hyperkalemia Sesẽ & Metabolic Acidosis Ðo\n3. Hemodialysis Kaba ne Oliguric Renal Failure, Acidosis, alo Refractory Shock Dzɔ\n4. Le Glufosinate gome la: Lé ŋku ɖe Coma, Yagbɔgbɔ, Kple Alɔ̃madɔmadɔ Siwo Metsina O Ŋu 24-48h"]

Gbewutike Vevi Atɔ̃ Siwo Le Amegbetɔ ƒe Aɖi Me Tsɔtsɔ Sɔ Kple Wo Nɔewo¶

Togbɔ be gbewutike gbogbo aɖewo li hã la, atike ƒe hatsotso atɔ̃ gbɔe agbledede kple aƒeme gbewutikewo ƒe nɔnɔme kpata siwo katã kloe dea ame ƒe agbe afɔku me le xexeame katã:

Deep Dive: Paraquat Poisoning: Dɔlélenutsiŋutete, Dɔdaƒe ƒe Akpawo, Kple Oxygen Se¶

1. Nusita Paraquat Tsrɔ̃a Aklãwo Tiatia (The Polyamine Transporter Trap) .¶

Ne paraquat ge ɖe ʋuka me tso dɔgboa me alo to ŋutigbalẽ si gblẽ me la, ema yia ŋutinuwo katã me, si wɔnɛ be necrosis kaba le ayiku ƒe ayiku ƒe ʋuka siwo te ɖe eŋu kple aklã me. Gake dzɔgbevɔ̃e tɔxɛ aɖe si wua ame la kpea fu na aklãwo: - Type I kple Type II alveolar epithelial cells le amegbetɔ ƒe lãkusi me la ƒe lãmekawo ƒe ʋuʋu ƒe ɖoɖo si nɔa te ɖe ŋusẽ dzi si woyɔna be polyamine uptake system (zi geɖe la, wozãnɛ tsɔ tsɔa endogenous polyamines abe putrescine kple spermine ene vaa dukɔa me). - Elabena didime si le nitrogen atɔm eve siwo me dzoxɔxɔ nyui le le paraquat molecule (0.7 nanometers) ƒe wɔwɔme sɔ kple dzɔdzɔme polyamines, aɖuɖɔtoewo tsɔa ya ƒua paraquat doa goe le ʋua me vodadatɔe tsɔ tsia tre ɖe eƒe agbɔsɔsɔme ƒe tɔtrɔ gã aɖe ŋu, eye wòɖoa lãkusi me lãmenugbagbeviwo ƒe agbɔsɔsɔ si lolo wu esi le ʋumenugbagbevi dzĩ me zi gbɔ zi 10 va ɖo 50** le gaƒoƒo geɖe me. - Ne paraquat ( .PQ2+) xɔa elektrɔnik aɖe tso NADPH (si NADPH-cytochrome P450 reductase ʋãna) be wòazu paraquat monocation free radical (PQ.+). - Radical sia tsɔa eƒe elektrɔnik si sɔ gbɔ wu la yia molecular oxygen ( .O2), si gbugbɔa paraquat ion gbãtɔa (PQ2+) esime wòle superoxide anion radical (O2.-), Haidrodzin peroxide ( .H2O2), kple hayidroxil ƒe ʋeʋẽ ( .OH.). - redox ƒe tsatsam sia si yia edzi la ɖua lãmenugbagbeviwo ƒe NADPH kple glutathione katã, enaa lãmenugbagbeviwo ƒe lãkusi me amiwo peroxidize, eʋãa alveolitis (aɖuɖɔtoedɔléle) sesẽ le gaƒoƒo 24 va ɖo 72 me, eye wòʋãa fibroblasts kple collagen ƒe dzidziɖedzi gã aɖe si trɔa lãkusia ƒe ya kotoku siwo le abe sponge ene wozua nu sesẽ, abi ƒe lãkusi si megbɔa ya o (honeycomb pulmonary fibrosis) le ŋkeke 5 va ɖo 21 me.

2. Nusita Ayiku ƒe Agbetsitsie Fia Aklã ƒe Agbetsitsi¶

Paraquat mewɔa metabolized le amegbetɔ ƒe ŋutilã me o; ayikuawo ɖea paraquat si woxɔ la ƒe alafa memama 90 kple edzivɔ doa goe matrɔmatrɔe to glomerular filtration kple active tubular secretion siaa dzi le gaƒoƒo 12 va ɖo 24 gbãtɔawo me, ne ayiku ƒe dɔwɔwɔ gakpɔtɔ le ɖoɖo nu. - Gake paraquat nana ayikuawo ƒe acute tubular necrosis (ATN) le gaƒoƒo 24 gbãtɔawo me le ɣeyiɣi ɖeka me. - Ne ayikuawo nya do kpo dɔwɔwɔ ko la, paraquat ƒe dodo le aɖuɖɔ me nu tsona, paraquat ƒe agbɔsɔsɔ le ʋumenugbagbevi dzĩ me nɔa dzi yim ŋkeke geɖe, eye lãkusiwo yia edzi ɖea paraquat doa goe le ʋua me vaseɖe esime woɖo aklã ƒe agba si wua ame gbɔ. - Eyata tsi si wodona ɖe ʋuka me vevie be woalé aɖuɖɔ ƒe dodo ɖe te kple ʋu si woɖena le ŋutilã godo kabakaba ŋutɔ (Charcoal Hemoperfusion alo Hemodialysis le gaƒoƒo 2 va ɖo 4 me tso esime woɖui) le vevie ŋutɔ be woaɖe paraquat ɖa le ʋua me hafi ayiku ƒe dɔmawɔmawɔ nyuie naxee ɖe ŋutilãa me.

3. Paraquat Nono ƒe Dɔdaƒe ƒe Akpa Etɔ̃ Siwo Nɔ te Ðe Agbɔsɔsɔme Dzi¶

4. Afɔku Siwo Le Lãgbalẽ (Ŋutilã) Kple Ŋku me Paraquat Ƒe Afɔkuwo Me¶

Mègabu ŋutigbalẽ ƒe paraquat zazã nu tsɛe gbeɖe o: - Togbɔ be ŋutigbalẽ si le lãmesẽ me si me gblẽ o la xɔa paraquat vivivi hã la, ne wòka asi atawui alo afɔkpa siwo me paraquat le ŋu ɣeyiɣi didi (abe akplo me atike si le sisim le agbledela ƒe akɔta, akɔta, kple akɔta) hea atike siwo gblẽa nu le ame ŋu ƒe dzobibi kple abi le ŋutigbalẽa ŋu tẽ. - Ne wonya fiã, lãe, ƒoe, alo ʋu si le gota gome ko la, paraquat gena ɖe ʋu si le ʋukawo me kabakaba to ŋutigbalẽ si gblẽ la me, eye aklã me fibrosis ƒe dɔléle gbogbo aɖewo siwo wua ame la dzɔ tso dermal backpack-sprayer leaks me keŋkeŋ evɔ womemi tsi ɖeka pɛ hã o. - Ŋku ƒe ʋuʋu kple paraquat si me wode nu me hea ŋkume kple ŋkume ƒe lãkusi ƒe ʋuʋu sesĩe si nu sẽna ɖe edzi le gaƒoƒo 12 va ɖo 48 le eƒe dodo vɔ megbe, si bia be woade tsi tsi/dzetsi aɖabaƒoƒo 20 enumake eye woakpɔ ŋkudɔlélewo gbɔ kpata be woaxe mɔ ɖe ŋkume ƒe abi si nɔa anyi ɖaa kple ŋkumaʋumaʋu nu.

Afɔɖeɖe Kɔdzi kple ICU ƒe Ðoɖowɔɖi na Paraquat kple Diquat¶

1. Mɔxexe Ðe Oxygen Nu Sesẽ (SpO2 Taɖodzinu 85% va ɖo 88%):
2. De dzesi aɖe si woate ŋu akpɔ le aba dzi le dɔnɔa ƒe ta tame: "PARAQUAT POISONING: MÈGADO OXYGEN KPEKPEÐEŊU AME NE BE SpO2 < 85% (PaO2 < 50 mmHg)."
3. Na dɔnɔa nanɔ gbɔgbɔm xɔme ya (FiO2 21%) ɣeyiɣi didi si wòanya wɔ.
4. Dɔgbome ƒe ɖiƒoƒo ɖeɖeɖa Enumake (Le Aɖabaƒoƒo 60 Me):
5. Na Atike si Wowɔna (1 to 2 g/kg, alo 50 to 100 grams le ame tsitsiwo me) to nu me alo to nasogastric tube falɛfalɛ si woda nyuie dzi (alo 15% Fuller ƒe Anyigba [100 to 150 g] alo 7% Bentonite kpe ɖe cathartic abe mannitol/sorbitol ene ŋu ne wozã anyi). Egbegbe aɖiŋutinunya ŋuti numekuku siwo wowɔ le atikewɔƒewo ɖo kpe edzi be Activated Charcoal wɔa dɔ abe Fuller ƒe Anyigba ene eye wodzrae ɖo ɖe dɔwɔƒe ɖesiaɖe si kpɔa nudzɔdzɔ kpatawo gbɔ xoxo; mègahe dzoka xɔxɔ ƒe lala be yeake ɖe Fuller ƒe Anyigba ŋu ɖe megbe gbeɖe o.
6. Ƒo asa na dɔgbo me tsilele edziedzi le caustic paraquat ɖuɖu vɔ megbe le afɔku gã si le esophageal perforation ta, negbe ɖe wowɔe blewuu to nasogastric aspiration me le miniti 30 va ɖo 60 me le tsi gbogbo aɖe ɖuɖu vɔ megbe.
7. Crystalloid Tsidede Ʋuka Me Dzikutɔe:
8. De isotonic kristalo ( .0.9% Normal Saline alo Lactated Ringer's) le 150 va ɖo 250 mL/gaƒoƒo be woalé aɖuɖɔ si dona kabakaba me ɖe asi (1.5 to 3 mL/kg/hour) eye woadzi ayiku me paraquat ɖeɖeɖa le lãme na ame geɖe wu le gaƒoƒo 24 gbãtɔ veviawo me.
9. Atike ƒe Ʋudodo Gbãtɔ (HP) alo Ʋumenugbagbeviɣidɔ (HD): Gaƒoƒo 2 va ɖo 4 ƒe Fesre:
10. Charcoal Hemoperfusion (alo High-Flux Hemodialysis) ateŋu akɔ paraquat ɖa le ʋu me, gake ne paraquat gakpɔtɔ le tsatsam le ʋumenugbagbeviɣi me hafi wotu ɖe lãkusi me lãmenugbagbeviwo me KO.
11. Be agbetsitsi nanyo ɖe edzi le nuɖuɖu siwo wua ame le liƒo dzi me la, ele be woadze Charcoal Hemoperfusion (alo Hemodialysis) gɔme le gaƒoƒo 2 va ɖo 4 (eye megawu gaƒoƒo 6 o) le nuɖuɖua ɖuɖu vɔ megbe, eye zi geɖe la, Continuous Venovenous Hemofiltration (CVVH) kplɔe ɖo. Ne gaƒoƒo 12 va ɖo 24 nya va yi ko la, paraquat ƒe agbɔsɔsɔ le ʋu me dzi ɖena kpɔtɔna xoxo elabena aɖia le lãkusia me, eye ɖeko ayiku ƒe dɔmawɔmawɔ nyuie doa alɔ ayiku ƒe dɔmawɔmawɔ nyuie.
12. Mɔƒe Kpata ƒe Dɔlélewo Didi ƒe Kpeɖodzi (Aɖuɖɔtoe Sodium Dithionite Dodokpɔ & Plasma Nomogram):
13. Aɖuɖɔ Sodium Dithionite Colorimetric Test: Ne wotsɔ sodium bicarbonate gram 1 kple sodium dithionite gram 1** de dɔnɔa ƒe aɖuɖɔ 10 mL me la, eɖea paraquat dzi kpɔtɔna va zua eƒe free-radical ion blɔ (eye wòɖea diquat dzi kpɔtɔna wòzua yibɔ-amadede dzẽ ion si klẽna).
    • Ne aɖuɖɔa trɔ dark navy blue alo blue-black le gaƒoƒo 6 va ɖo 24 me le eɖuɖu vɔ megbe la, eɖoa kpe paraquat ƒe agba gã aɖe si le ɖoɖo nu si me ku geɖe ŋutɔ le dzi.
    • Ne aɖuɖɔa tsi ekɔ alo blɔ keklẽ si me kɔ la, aɖuɖɔtoea ƒe xɔxlɔ̃ le ɖoɖo nu mesɔ gbɔ o eye anɔ eme be atsi agbe.
14. Agbɔsɔsɔme ƒe Plasma Paraquat Nomogram (Proudfoot / Hart Nomograms): Agbɔsɔsɔme si tututu le plasma paraquat ƒe agbɔsɔsɔme ƒe nɔnɔmetata wɔwɔ (mcg/mL alo mg/L) tsɔ wu gaƒoƒo siwo woxɔ tso esime wonoe la gblɔa agbetsitsi ƒe kakaɖedzi ɖi.
15. Dɔlélenutsiŋutete kple Antioxidant ICU Xɔname Dɔwɔɖoɖo:
16. Be woaxe mɔ ɖe aklã me ʋuka me dɔléle sesẽ kple fibroblast collagen ƒe sisi nu la, dukɔwo dome aɖiŋutinunyalawo ƒe dɔwɔƒe geɖe (vevietɔ le Asia-Pacific katã kple le WHO/NPIS ƒe dɔdamɔnu ƒe mɔfiamewo me) naa dɔlélenutsiŋutete kple antioxidant ƒe ɖoɖo kaba le paraquat aɖi si le titina va ɖo esi nu sẽ me:
    • Methylprednisolone si wodona ɖe ʋuka me (15 mg/kg/day alo 1,000 mg IV daily for 3 days) + Cyclophosphamide si wodona ɖe ʋuka me (15 mg/kg/day IV for 2 days), eye Dexamethasone (8 mg IV every 8 hours).
    • N-Acetylcysteine (NAC) si wodona ɖe ʋuka me ƒe agbɔsɔsɔ gã aɖe** (be woatsɔ agbugbɔ glutathione si le lãmenugbagbeviwo me ade eme), Vitamin C (Ascorbic Acid) si wodona ɖe ʋuka me ƒe agbɔsɔsɔ gã aɖe, Vitamin E, kple Sodium Salicylate (si wɔa chelate na iron, ɖea hydroxyl radicals ɖa, eye wòxea mɔ ɖe enu NF-kappaB lãkusi ƒe dɔdzẽ).
17. Vevesese dzi ɖeɖe kpɔtɔ kple vevesesenutsitike:
18. Nu me, aɖuɖɔtoe, kple nuɖuɖutome ƒe abi siwo ʋãa ame ("paraquat tongue") hea vevesese sesẽ vɛ; na opioid vevesesenutsitike si wodona ɖe ʋuka me (morphine alo fentanyl) kple lidocaine viscous nu me tsilele, eye nàna dɔnɔa nanɔ nu me to nu me (NPO) kple nunyiame si wotsɔa nu me ne nuɖuɖutome ƒe dzobibi sesẽwo le eme.

Glyphosate-Surfactant ("Roundup") ƒe aɖi ƒe vovototodedeameme si me wodea aɖinuwoe¶

Esi wònye be glyphosate ye nye gbewutike si wozãna wu le xexeame ta la, aɖidɔwɔƒewo dea vovototo **aƒetɔ ƒe atike siwo wotsɔ ƒua gbe si woate ŋu azã ** kple agblemenuku siwo wotsɔ ƒoa ƒui dome vevie:

• Aƒetɔ ƒe Atike si Wozãna (RTU) (1% to 2% Glyphosate): Zi geɖe la, ɖevi alo ame tsitsi aɖe mimi nu me le vo me la, nu me ƒe dzikudodo si seɖoƒe li na eɖokui, ʋuʋudedi fafɛ, ʋuʋudedi, alo aɖuɖɔtoe si nu metsina o kple ŋkuléle ɖe eŋu me koe wòhena vɛ.
• Agbledede / Asitsatsa ƒe Nuku (41% to 50%+ Glyphosate + 15% POEA Surfactant):
• Glyphosate-surfactant 41% si me wode nu me si wu wu 85 mL va ɖo 100 mL (3 ounces) mimi nye beléle kpata si ate ŋu ade ame ƒe agbe afɔku me eye amewuwu ƒe agbɔsɔsɔme nye 10 va ɖo 30 le alafa me ne woɖoe koŋ zãe wògbɔ eme.
• Gakpe ɖe eŋu la, glyphosate ƒe atike aɖewo siwo wodzrana siwo ŋu ŋusẽ le ŋutɔ zãa Glyphosate Potassium Salt (K+ dze) ɖe isopropylamine dze teƒe: potassium-glyphosate ƒe atike si me wode nu me mimi naa potassium ƒe agba gã aɖe si tso gota si ate ŋu ana dzi ƒe dɔmawɔmawɔ nyuie si wua ame enumake le gaƒoƒo 1 va ɖo 3 me.
• Kɔdzidzikpɔkpɔ: Wɔ nasopharyngoscopy si te ŋu trɔna enumake kple endotracheal intubation kaba ne tsi le dodom, stridor, alo pharyngeal edema le eme; gbugbɔ ʋu ƒe sisi aɖo anyi kple aggressive IV crystalloids kple norepinephrine; atsɔ IV calcium, insulin-dextrose, kple sodium bicarbonate ada ʋumenugbagbeviɣidɔ si sɔ gbɔ ɖe lãme na ame enumake; eye woadze ʋumenugbagbeviɣidɔ kaba gɔme ne refractory metabolic acidosis, hyperkalemia, oliguric acute kidney injury, alo shock gakpɔtɔ li.

Mɔxexe Ðe Enu: Nu #1 si gbɔ gbewutike si wua ame le vo me tsona¶

Nutome ƒe xexlẽdzesi siwo ku ɖe nudzɔdzɔ kpatawo ŋu kple dɔwɔƒea ƒe ɖoɖowo¶

Nya siwo wobiaa amewo enuenu¶

Nukatae wòle be kpekpeɖeŋunalawo kple ɖɔkta siwo kpɔa nudzɔdzɔ kpatawo gbɔ naxe mɔ na oxygen kpeɖeŋutɔ na amesi mi paraquat?¶

Paraquat wua lãkusi me lãmenugbagbeviwo to atike aɖe si woyɔna be redox cycling dzi, si zãa oxygen molecule siwo le lãkusia me tsɔ wɔa superoxide kple hydroxyl free radicals miliɔn geɖe siwo gblẽa nu. Esi wònye be lãkusiwo tsɔa paraquat doa goe le ʋukawo me vevie va ɖoa agbɔsɔsɔ si sɔ gbɔ wu ŋutilãa ƒe teƒe bubu ɖesiaɖe zi gbɔ zi 10 va ɖo 50 ta la, oxygen kpeɖeŋutɔ nana naa ami bubu na atike ma eye wònaa abi si wua ame ƒe lãkusi (aklã me lãkusi) kabakaba ŋutɔ. Ele be atikewɔlawo ƒe ƒuƒoƒowo nana paraquat dɔnɔwo nagbɔ xɔa me ya si sɔ eye ne oxygen ƒe agbɔsɔsɔ si le ʋu me (SpO2) ɖiɖi wu 85 va ɖo 88 le alafa me (PaO2 si mede 50 mmHg o) ko hafi woana oxygen kpeɖeŋutɔ.

Nukatae woyɔa miniti 60 gbãtɔ siwo kplɔa paraquat mimi ɖo be "Sika Gaƒoƒo"?¶

Woxɔa paraquat kabakaba ŋutɔ tso dɔgbo suea me, eye wòɖoa eƒe agbɔsɔsɔ gãtɔ kekeake le ʋukawo me le miniti 60 va ɖo 120 me, eye emegbe wotsɔa eƒe dɔwɔwɔ dea aɖuɖɔtoe me lãmenugbagbeviwo me afisi atike alo ʋumenugbagbeviɣidɔlékui aɖeke mate ŋu ahee ado goe gbeɖe o. Activated Charcoal (alo Fuller’s Earth / Bentonite clay) mimi le miniti 60 gbãtɔwo me blaa paraquat si nye tsi la ɖe dɔgboa kple dɔgbowo me hafi te ŋu gena ɖe ʋukawo me, si ate ŋu afia vovototo si le agbetsitsi kple lãkusi me fibrosis si wua ame dome.

Ðe nàte ŋu axɔ aɖi si wua ame si woyɔna be paraquat ne èkɔ ɖe wò ŋutigbalẽ dzi evɔ mèmi ɖeke oa?¶

Ɛ̃. Paraquat si me wode nu me nye atike si gblẽa nu le ŋutigbalẽ ŋu si fiãa ŋutigbalẽ eye wògbãnɛ ne eƒoe. Ne paraquat do tso akplo me atike si wotsɔna ƒua gbe me yi dɔwɔla ƒe akɔta, afɔwo, alo akɔta, alo ƒu kplakplakpla ɖe ŋutigbalẽ si ŋu wotso, ƒo, ƒo, alo ƒo xoxo la, etoa ŋutigbalẽ ƒe mɔxenu si gblẽ la me kabakaba yia ʋukawo me eye wòzɔa mɔ yia lãkusiwo me, si wɔnɛ be aklã me lãkusi si wua ame abe alesi tututu wòmia aɖia ene. Ne paraquat ka ŋutigbalẽa ŋu la, ɖe awuwo katã ɖa enumake eye nàtsɔ adzalẽ kple tsi si le sisim aklɔe blewu aɖabaƒoƒo 15 va ɖo 20 màtutu eŋu sesĩe o (etutu ŋutigbalẽa ƒoa ŋutigbalẽa eye wònana wòxɔa kabakaba).

Vovototo kae le Roundup atike si wozãna le aƒeme kple Roundup si wozãna le agble me ne womie le vo me dome?¶

Glyphosate si woɖe ɖe tsi me ƒe 1% va ɖo 2% koe le aƒeme abɔ me atikewutike siwo woate ŋu azã xoxo me; zi geɖe la, nu sue aɖe si womi le vo me nana nu me doa dziku vie alo dɔgbo ƒe dziku. To vovo na ema la, glyphosate 41% va ɖo 50% si wotsɔ tsaka kple atike siwo me wodea tsii (abe POEA ene) kple potassium dze siwo ƒe agbɔsɔsɔme sɔ gbɔ ɣeaɖewoɣi le gbewutike siwo wodona le agble me alo esiwo wodzrana me. Glyphosate-surfactant 41% si me wode tsii si wu 85 mL (anɔ abe ounces 3) mimi ate ŋu ana ŋɔti nafiã vevie, yaƒoƒomɔ̃wo navuvu, ʋumenu si me potassium sɔ gbɔ ɖo si ate ŋu ade ame ƒe agbe afɔku me (hyperkalemia), lãmenugbagbeviwo ƒe acidosis, ayiku ƒe dɔmawɔmawɔ nyuie, kple dzidziƒoame si hiã beléle vevie.

Nukae nye "paraquat tongue" eye ɣekaɣie wòdzena?¶

Esi wònye be paraquat kple diquat si me wode nu me nye atike sesẽ siwo gblẽa nu ta la, ne womi nu sue aɖe gɔ̃ hã la, enaa nu, aɖe, kple ŋɔti biãna vevie. Le gaƒoƒo 24 va ɖo 48 me le eɖuɖu vɔ megbe la, aɖea ƒe gowo vuvu, ʋuʋuna, eye wòɖena, eye wòva tsyɔa nu ɣi ɣi siwo le vevem kple abi siwo le dodom siwo woyɔna le atikewɔnyawo me be "paraquat tongue" me. Ne dɔnɔa ɖe tsi akpa gãtɔ do goe gɔ̃ hã la, alesi nu me dzobibi le la ɖo kpe edzi be exɔe eye wòhiã be woaxɔe ɖe kɔdzi enumake be woalé ŋku ɖe ayiku kple lãkusi ƒe dɔwɔwɔ ŋu.

Mɔfiame siwo do ƒome kplii¶

• Organophosphate nudzodzoeviwutike, lãmekawo ƒe dɔwɔwɔ, kple nudzodzoeviwutike ƒe aɖi
• Aɖi si le sisiblisiwo ɖuɖu me: Superwarfarin, bromethalin, kple zinc phosphide
• Aɖi ƒe kpekpeɖeŋunana gbãtɔ kple aɖidzikpɔkpɔ ƒe vovototodedeameme
• Dzobibi kple dzobibi kpekpeɖeŋunana gbãtɔ (siwo dome atikewo ƒe dzobibi hã le) .
• Ayiku ƒe abixɔxɔ sesẽ, rhabdomyolysis, kple aɖuɖɔtoe ƒe vovototodedeameme viviti

Dzɔtsoƒewo kple dziɖuɖumegãwo ƒe mɔfiame¶

• United States ƒe Nutome Takpɔha (EPA): Aɖiwutikewo ƒe Dzesidede Kple Wo Dzi Kpɔkpɔ (Tata 6 lia): Paraquat, Diquat, Glyphosate, kple Chlorophenoxy Gbewutikewo.
• Xexeame ƒe Lãmesẽ Habɔbɔ (WHO) & Nuɖuɖu kple Agbledede Habɔbɔ (FAO): Paraquat kple Bipyridylium Gbewutikewo ƒe Aɖi ƒe Dɔdamɔnu.
• Dɔlélenutsitsi Kple Mɔxexe Ðe Enu Dɔwɔƒewo (CDC): Dzadzraɖo Ðe Nudzɔdzɔ Kpatawo Ŋu Kple Wo Ŋuɖoɖo: Nyateƒenyawo Ku Ðe Paraquat Atikewo Ŋuti Nudzɔdzɔ Kpatawo Kple Ðiƒoƒo Ŋu.
• Dukɔa ƒe Aɖiwo Ŋuti Nyatakaka Dɔwɔƒe (NPIS, United Kingdom): TOXBASE Dɔdaƒe ƒe Dɔdamɔnudzikpɔkpɔ le Paraquat, Diquat, Glyphosate, kple Glufosinate Aɖiwo Ŋu.
• EXTRIP (Extracorporeal Treatments in Poisoning) & Dukɔwo Dome Atikewɔwɔ ƒe Aɖiŋutinunya ƒe Mɔfiamewo: Ʋudodo Gbãtɔ, Ʋumenugbagbeviɣidɔ, kple Dɔlélenutsiŋutete ƒe Dɔdamɔnu le Paraquat kple Chlorophenoxy Gbewutike ƒe Aɖi me.

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Mɔfiame sia nye nyatakaka nana eye mexɔ ɖe atikewɔla bibiwo ƒe atikewɔwɔ me dzodzro, Aɖidzikpɔkpɔ ƒe aɖaŋuɖoɖo, alo kɔdzi ƒe dɔnɔdzikpɔkpɔ vevie teƒe o. Esi wònye be gbewutike gbogbo aɖewo zazã ate ŋu ana yaƒoƒomɔ̃wo natɔ dzo kabakaba, awɔ nuku na ame, eye gbɔgbɔtsixe natsi ta la, míele aɖaŋu ɖom vevie be nàwɔ kpekpeɖeŋunadɔ gbãtɔ kple CPR ƒe hehexɔxɔ si ŋu woda asi ɖo to Dukɔwo Dome Atitsoga Dzĩ Habɔbɔ kple Ɣleti Dzĩ Habɔbɔwo ƒe Habɔbɔ (IFRC), wò dukɔa ƒe Atitsoga Dzĩ Habɔbɔ, St John Ambulance, alo nutoa me dɔwɔƒe si ŋu woɖo kpee dzi.