Potassium Chlorate Poisoning

Aka: Potassium Chlorate Poisoning, Potassium Chlorate Toxicity, Potassium Chlorate Overdose, Potassium Chlorate

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II. Pathophysiology

  1. Potassium Chlorate (KClO3) is a strong oxidizer
  2. Potassium Chlorate (KClO3) Sources
    1. Commonly used industrial solution as an Oxidant
    2. Fireworks, explosives and propellants (e.g. firearm percussion caps)
    3. Disinfectant or medical mouthwash
    4. Match heads
    5. Herbicides
    6. Chemical oxygen generation
    7. Dyes

III. Pharmacology

  1. Lethal dose
    1. Infant: >1 g (equivalent to 20 match heads)
    2. Adult: >5 g
  2. Pharmacokinetics
    1. Rapid gastrointestinal absorption
    2. May also be absorbed via inhalation
    3. Slow renal excretion

IV. Findings

  1. Gastrointestinal
    1. Mucosal irritation
    2. Nausea or Vomiting
  2. Hematologic
    1. Methemoglobinemia
    2. Hemolysis
  3. Renal
    1. Acute Tubular Necrosis (Acute Renal Failure)
  4. Hepatic
    1. Hyperbilirubinemia

V. Labs: Symptomatic Exposure

  1. See Unknown Ingestion
  2. Complete Blood Count
    1. Trend levels (e.g. Hemoglobin) in symptomatic patients
  3. Comprehensive Metabolic Panel
    1. Acute Renal Failure
  4. Coagulation Labs
    1. Obtain if findings suggest Hemolysis
  5. Urinalysis
  6. Methemoglobin level
    1. Obtain in cyanotic patients
    2. Trend levels in symptomatic patients

VI. Management

  1. Supportive Care
    1. Intravenous Fluids
    2. Supplemental Oxygen as needed
  2. Methemoglobinemia
    1. Methylene Blue
      1. Dose: 1 mg/kg now and may repeat in 1 hour
      2. Avoid in G6PD Deficiency
  3. Renal Failure
    1. Hemodialysis
  4. Severe Poisoning Additional Measures
    1. Exchange Transfusion
  5. Disposition of asymptomatic patients
    1. May discharge home at 6 hours if still asymptomatic

VII. Resources

  1. Potassium Chlorate (Wikipedia)
    1. https://en.wikipedia.org/wiki/Potassium_chlorate
  2. Potassium Chlorate (Pubchem)
    1. https://pubchem.ncbi.nlm.nih.gov/compound/Potassium-chlorate

VIII. References

  1. Tomaszewski (2023) Crit Dec Emerg Med 37(2): 32

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