Paraquat and Diquat

Paraquat and Diquat is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Paraquat is a restricted use herbicide that is safe when used per the manufacturer’s label but exhibits marked toxicity when ingested. Ingestions of paraquat usually result in death from fulminant respiratory failure.

Epidemiology

Although paraquat poisoning is rare in the United States, it is a leading cause of poisoning mortality in Asia-Pacific and Latin America.1 Diquat poisoning is much less common with only 30 cases presented in the literature between 1968–1999.2

Pathophysiology

The paraquat molecule is actively transported into the lung by a polyamine transporter and cause oxidative injury to the Type I and Type II alveolar cells resulting in rapid fibrosis of the alveoli.3 Although diquat has a similar toxicity profile, pulmonary injury is less frequent because of the structure of the molecule. Diquat does cause tubular necrosis of the kidney and renal failure is the prominent feature of diquat ingestions.2

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General Principles

Paraquat is a restricted use herbicide that is safe when used per the manufacturer’s label but exhibits marked toxicity when ingested. Ingestions of paraquat usually result in death from fulminant respiratory failure.

Epidemiology

Although paraquat poisoning is rare in the United States, it is a leading cause of poisoning mortality in Asia-Pacific and Latin America.1 Diquat poisoning is much less common with only 30 cases presented in the literature between 1968–1999.2

Pathophysiology

The paraquat molecule is actively transported into the lung by a polyamine transporter and cause oxidative injury to the Type I and Type II alveolar cells resulting in rapid fibrosis of the alveoli.3 Although diquat has a similar toxicity profile, pulmonary injury is less frequent because of the structure of the molecule. Diquat does cause tubular necrosis of the kidney and renal failure is the prominent feature of diquat ingestions.2

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