Aluminum Phosphide Poisoning, Mechanism of Action and Treatment: a Literature Review

Document Type: Review Article


1 Ph.D. Candidate Medical Toxicology Research Centere, Faculty of Medicine Mashhad University of Medical Sciences, Mashhad, Iran

2 Ph.D. Candidate Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

3 Associate Professor, Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Assistant Professor, Emergency Medicine Department, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran


Aluminum phosphide (AlP) is an important fumigant, a commendable and very effective outdoor and indoor insecticide. AlP, locally named “rice tablet”, is widely used to protect rice. As soon as taking a very small amount of an AlP tablet, phosphine vaporizes due to the exposure to the air and affects different kinds of organs. Although, in most cases, clinical history can help making the final diagnosis, analytical tests such as gas chromatographic method in post-mortem specimens and survivors have been developed to measure the level of phosphine and to distinguish between ZnP and AlP poisoning.
AlP poisoning management should be started quickly. In addition to supportive therapy, various antioxidant agents, as candidate protective factors, such as N-acetylcysteine (NAC), melatonin, glutathione, magnesium, β-carotene, and vitamin C and E have also been recommended to decrease oxidative damage and cardiotoxicity due to the limited antioxidant defense systems.
The present study highlights the fact that Antioxidant therapy in severe ALP poisoning confers different survival benefits. This literature review showed that the administration of antioxidant therapy in addition to the supportive treatment may decrease the mortality rate and could be considered in the treatment of acute AlP poisoning in combination with other therapeutic protocols.


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