II. Background
- Glyphosate is the most commonly used herbicide in the United States (e.g. Roundup)
- Concentrations vary considerably (41% for commerical use, <1% for home use)
- Herbicides are a combination of isopropylamine (IPA) salt of Glyphosate, surfactant and other additives
III. Mechanism
- Nearly all Poisoning cases are from intentional ingestion
- Bioavailability after ingestion: 30%
- Uncouples Oxidative Phosphorylation
- Cell membrane disruption
- Surfactant additives to the Glyphosate may cause Hypotension
- Skin penetration <1%
- Low inhalational exposure
IV. Findings: Acute Ingestion
- Gastrointestinal Findings
- Abdominal Pain
- Nausea and Vomiting
- Diarrhea
- Gastrointestinal Hemorrhage
- Cardiopulmonary Findings
- Hypotension (Hypovolemia, Dehydration)
- Dysrhythmias (Bradycardia and ventricular Arrhythmias, esp. if Hyperkalemia)
- Pulmonary Edema
- Neurologic Findings
- Miscellaneous Findings
V. Labs
- See Unknown Ingestion
- Serum Chemistry Panel
- Hyperkalemia
- Acute Kidney Injury (increased Serum Creatinine)
- Rhabdomyolysis (increased Creatine Phosphokinase)
- Blood Gas
VI. Imaging
- Consider Chest XRay
VII. Diagnostics
VIII. Management
- See Unknown Ingestion
-
Decontamination
- Skin and eye Decontamination
- Supportive Care
- Fluid Resuscitation
- Hemodialysis
- May be indicated in Acute Renal Failure
- Disposition
- Observe for at least 6 hours after intentional ingestion
- Admit for refractory gastrointestinal symptoms or serious findings (gastrointestinal Hemorrhage)
IX. Complications
- WHO labels as likely carcinogen (but not U.S. EPA or European EFSA)
- Non-Hodgkin's Lymphoma association
X. References
- Tomaszewski (2019) Crit Dec Emerg Med 33(5):32
- Bradberry (2004) Toxicol Rev 23(3):159-67 +PMID:15862083 [PubMed]
- Mahendrakar (2014) Indian J Crit Care Med 18(5): 328–330 [PubMed]
XI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047698/
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Related Studies
| Concepts | Hazardous or Poisonous Substance (T131) , Organophosphorus Compound (T115) |
| MSH | C010974 |
| SnomedCT | 311727006 |
| LNC | LP34417-3, MTHU017386 |
| English | glyphosate, N-(phosphonomethyl)glycine, Glyphosate, Gluphosate (substance), Glyphosate (substance), Gluphosate, gliphosate |
| Spanish | glifosato, glifosato (sustancia), glufosato (sustancia), glufosato |
Ontology: Gluphosphate causing toxic effect (C0413074)
| Concepts | Injury or Poisoning (T037) |
| SnomedCT | 241794003 |
| English | Gluphosphate caus toxic effect, Gluphosphate causing toxic effect, Gluphosphate causing toxic effect (disorder) |
| Spanish | glucofosfato que causa efectos tóxicos (trastorno), glucofosfato que causa efectos tóxicos |
