Research Article

Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial

Volume: 29 Number: 2 April 8, 2025
EN

Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial

Abstract

Aluminum phosphide (AlP) is a leading cause of pesticide poisoning worldwide, with the heart being the critical organ most affected by its toxic effects. This randomized controlled clinical trial aimed to evaluate the potential protective effects of acetyl-L-carnitine (ALC) against AlP poisoning. The study involved forty-four patients poisoned with aluminum phosphide, randomly allocated to either the intervention group, which received basic treatment along with a 1g infusion of ALC upon arrival at the hospital and every 8 hours thereafter, or the control group, which received basic treatment alone. The study assessed the association between demographic and poisoning-related factors and mortality during hospital stays in both groups. The results showed that the mortality rate was substantially lower in the ALC group (45.4%, n=10) compared to the non-ALC group (77.3%, n=17), but it was not significant (P = 0.06). Additionally, the length of hospital stay was significantly shorter for patients in the ALC group compared to those in the control group, and after therapeutic intervention, patients in the ALC group exhibited a statistically significant elevation in ejection fraction compared to the control group. Preliminary results suggest that ALC treatment alongside standard care might reduce mortality and hospital stay in AlP-poisoned patients, albeit without detectable side effects. However, these findings are initial and should be approached with caution. They are not definitive, and larger, more comprehensive studies are vital for confirming ALC's efficacy and safety in clinical practice. The potential benefits of ALC in managing AlP poisoning warrant further investigation before widespread clinical application.

Keywords

References

  1. [1] Hashemi-Domeneh B, Zamani N, Hassanian-Moghaddam H, Rahimi M, Shadnia S, Erfantalab P, Ostadi A. A review of aluminium phosphide poisoning and a flowchart to treat it. Arh Hig Rada Toksikol. 2016;67(3):183-193. https://doi.org/10.1515/aiht-2016-67-2784
  2. [2] Mehrpour O, Singh S. Rice tablet poisoning: A major concern in Iranian population. Hum Exp Toxicol. 2010;29(8):701-702. https://doi.org/10.1177/0960327109359643
  3. [3] Bagherian F, Kalani N, Rahmanian F, Abiri S, Hatami N, Foroughian M, Mehramiz NJ, Shahi B. Aluminum Phosphide Poisoning Mortality Rate in Iran; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2021;9(1):e66. https://doi.org/10.22037%2Faaem.v9i1.1396
  4. [4] Wahab A, Zaheer M, Wahab S, Khan R. Acute aluminium phosphide poisoning: an update. Hong Kong J Emerg Med. 2008;15(3):152-155. https://doi.org/10.1177/102490790801500306
  5. [5] Anand R, Binukumar B, Gill KD. Aluminum phosphide poisoning: An unsolved riddle. J Appl Toxicol. 2011;31(6):499-505. https://doi.org/10.1002/jat.1692
  6. [6] Gülcin I. Antioxidant and antiradical activities of L-carnitine. Life Sci. 2006;78(8):803-811. https://doi.org/10.1016/j.lfs.2005.05.103
  7. [7] Elgazzar FM, Keshk W, Khalifa H. Early L-carnitine therapy in severe acute aluminum phosphide poisoning: A randomized controlled clinical trial. Egypt J Forensic Sci Appl Toxicol. 2019;19(4):147-164. https://dx.doi.org/10.21608/ejfsat.2020.17184.1097
  8. [8] Baghaei A, Solgi R, Jafari A, Abdolghaffari AH, Golaghaei A, Asghari MH, Baeeri M, Ostad SN, Sharifzadeh M, Abdollahi M. Molecular and biochemical evidence on the protection of cardiomyocytes from phosphine-induced oxidative stress, mitochondrial dysfunction and apoptosis by acetyl-L-carnitine. Environ Toxicol Pharmacol. 2016;42:30-37. https://doi.org/10.1016/j.etap.2015.12.019

Details

Primary Language

English

Subjects

Pharmacology and Pharmaceutical Sciences (Other)

Journal Section

Research Article

Authors

Hoorvash Faraji Dana This is me
Iran

Alireza Kargar This is me
Iran

Houra Yeganegi This is me
Iran

Mehdi Sheibani This is me
Iran

Amir Baghaei This is me
Iran

Publication Date

April 8, 2025

Submission Date

November 29, 2023

Acceptance Date

March 26, 2024

Published in Issue

Year 2025 Volume: 29 Number: 2

APA
Faraji Dana, H., Kargar, A., Shadnia, S., Rahimi, M., Yeganegi, H., Sheibani, M., Baghaei, A., & Erfan Talab Evini, P. (2025). Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial. Journal of Research in Pharmacy, 29(2), 705-712. https://doi.org/10.12991/jrespharm.1664915
AMA
1.Faraji Dana H, Kargar A, Shadnia S, et al. Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial. J. Res. Pharm. 2025;29(2):705-712. doi:10.12991/jrespharm.1664915
Chicago
Faraji Dana, Hoorvash, Alireza Kargar, Shahin Shadnia, et al. 2025. “Acetyl-L-Carnitine Effect on Acute Aluminum Phosphide Poisoning: A Randomized Control Trial”. Journal of Research in Pharmacy 29 (2): 705-12. https://doi.org/10.12991/jrespharm.1664915.
EndNote
Faraji Dana H, Kargar A, Shadnia S, Rahimi M, Yeganegi H, Sheibani M, Baghaei A, Erfan Talab Evini P (April 1, 2025) Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial. Journal of Research in Pharmacy 29 2 705–712.
IEEE
[1]H. Faraji Dana et al., “Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial”, J. Res. Pharm., vol. 29, no. 2, pp. 705–712, Apr. 2025, doi: 10.12991/jrespharm.1664915.
ISNAD
Faraji Dana, Hoorvash - Kargar, Alireza - Shadnia, Shahin - Rahimi, Mitra - Yeganegi, Houra - Sheibani, Mehdi - Baghaei, Amir - Erfan Talab Evini, Peyman. “Acetyl-L-Carnitine Effect on Acute Aluminum Phosphide Poisoning: A Randomized Control Trial”. Journal of Research in Pharmacy 29/2 (April 1, 2025): 705-712. https://doi.org/10.12991/jrespharm.1664915.
JAMA
1.Faraji Dana H, Kargar A, Shadnia S, Rahimi M, Yeganegi H, Sheibani M, Baghaei A, Erfan Talab Evini P. Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial. J. Res. Pharm. 2025;29:705–712.
MLA
Faraji Dana, Hoorvash, et al. “Acetyl-L-Carnitine Effect on Acute Aluminum Phosphide Poisoning: A Randomized Control Trial”. Journal of Research in Pharmacy, vol. 29, no. 2, Apr. 2025, pp. 705-12, doi:10.12991/jrespharm.1664915.
Vancouver
1.Hoorvash Faraji Dana, Alireza Kargar, Shahin Shadnia, Mitra Rahimi, Houra Yeganegi, Mehdi Sheibani, Amir Baghaei, Peyman Erfan Talab Evini. Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial. J. Res. Pharm. 2025 Apr. 1;29(2):705-12. doi:10.12991/jrespharm.1664915

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