II. Background

  1. Glyphosate is the most commonly used herbicide in the United States (e.g. Roundup)
    1. Concentrations vary considerably (41% for commerical use, <1% for home use)
  2. Herbicides are a combination of isopropylamine (IPA) salt of Glyphosate, surfactant and other additives

III. Mechanism

  1. Nearly all Poisoning cases are from intentional ingestion
    1. Bioavailability after ingestion: 30%
    2. Uncouples Oxidative Phosphorylation
    3. Cell membrane disruption
    4. Surfactant additives to the Glyphosate may cause Hypotension
  2. Skin penetration <1%
  3. Low inhalational exposure

IV. Findings: Acute Ingestion

  1. Gastrointestinal Findings
    1. Abdominal Pain
    2. Nausea and Vomiting
    3. Diarrhea
    4. Gastrointestinal Hemorrhage
  2. Cardiopulmonary Findings
    1. Hypotension (Hypovolemia, Dehydration)
    2. Dysrhythmias (Bradycardia and ventricular Arrhythmias, esp. if Hyperkalemia)
    3. Pulmonary Edema
  3. Neurologic Findings
    1. Altered Mental Status
  4. Miscellaneous Findings
    1. Hyperkalemia
    2. Rhabdomyolysis

VI. Imaging

  1. Consider Chest XRay

VII. Diagnostics

VIII. Management

  1. See Unknown Ingestion
  2. Decontamination
    1. Skin and eye Decontamination
  3. Supportive Care
    1. Fluid Resuscitation
    2. Hemodialysis
      1. May be indicated in Acute Renal Failure
  4. Disposition
    1. Observe for at least 6 hours after intentional ingestion
    2. Admit for refractory gastrointestinal symptoms or serious findings (gastrointestinal Hemorrhage)

IX. Complications

  1. WHO labels as likely carcinogen (but not U.S. EPA or European EFSA)
  2. Non-Hodgkin's Lymphoma association
    1. Zhang (2019) Mutat Res 781:186-206 +PMID:31342895 [PubMed]

XI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047698/

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