Potassium permangante (PIM 409)

<HTML> <HEAD> <META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=iso-8859-1"> <TITLE>Potassium permangante (PIM 409)</TITLE> </HEAD> <BODY BGCOLOR="#FFFFFF"> <A HREF="http://www.inchem.org"><IMG SRC="../../inchemhead.jpg" WIDTH="630" HEIGHT="65" BORDER="0" ALT="IPCS INCHEM Home"></A><CENTER><H1>Potassium permangante</H1></CENTER> <CENTER><TABLE WIDTH=500> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:1. NAME">1. NAME</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:1.1 Substance">1.1 Substance</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:1.2 Group">1.2 Group</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:1.3 Synonyms">1.3 Synonyms</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:1.4 Identification Numbers">1.4 Identification Numbers</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:1.4.1 CAS number">1.4.1 CAS number</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:1.4.2 Other Numbers">1.4.2 Other Numbers</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:1.5 Main brand names, main trade names">1.5 Main brand names, main trade names</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:1.6 Main manufacturers, main importers">1.6 Main manufacturers, main importers</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:2. SUMMARY">2. SUMMARY</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:2.1 Main risks and target organs">2.1 Main risks and target organs</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:2.2 Summary of clinical effects">2.2 Summary of clinical effects</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:2.3 Diagnosis">2.3 Diagnosis</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:2.4 First-aid measures and management principles">2.4 First-aid measures and management principles</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:3. PHYSICO-CHEMICAL PROPERTIES">3. PHYSICO-CHEMICAL PROPERTIES</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:3.1 Origin of the substance">3.1 Origin of the substance</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:3.2 Chemical structure">3.2 Chemical structure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:3.3 Physical properties">3.3 Physical properties</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:3.3.1 Colour">3.3.1 Colour</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:3.3.2 State/Form">3.3.2 State/Form</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:3.3.3 Description">3.3.3 Description</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:3.4 Hazardous characteristics">3.4 Hazardous characteristics</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:4. USES">4. USES</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:4.1 Uses">4.1 Uses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:4.1.1 Uses">4.1.1 Uses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:4.1.2 Description">4.1.2 Description</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:4.2 High risk circumstance of poisoning">4.2 High risk circumstance of poisoning</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:4.3 Occupationally exposed populations">4.3 Occupationally exposed populations</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:5. ROUTES OF EXPOSURE">5. ROUTES OF EXPOSURE</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:5.1 Oral">5.1 Oral</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:5.2 Inhalation">5.2 Inhalation</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:5.3 Dermal">5.3 Dermal</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:5.4 Eye">5.4 Eye</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:5.5 Parenteral">5.5 Parenteral</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:5.6 Other">5.6 Other</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:6. KINETICS">6. KINETICS</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:6.1 Absorption by route of exposure">6.1 Absorption by route of exposure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:6.2 Distribution by route of exposure">6.2 Distribution by route of exposure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:6.3 Biological half-life by route of exposure">6.3 Biological half-life by route of exposure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:6.4 Metabolism">6.4 Metabolism</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:6.5 Elimination and excretion">6.5 Elimination and excretion</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:7. TOXICOLOGY">7. TOXICOLOGY</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:7.1 Mode of action">7.1 Mode of action</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:7.2 Toxicity">7.2 Toxicity</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:7.2.1 Human data">7.2.1 Human data</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:7.2.1.1 Adults">7.2.1.1 Adults</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:7.2.1.2 Children">7.2.1.2 Children</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:7.2.2 Relevant animal data">7.2.2 Relevant animal data</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:7.2.3 Relevant in vitro data">7.2.3 Relevant in vitro data</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:7.2.4 Workplace standards">7.2.4 Workplace standards</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:7.2.5 Acceptable daily intake (ADI)">7.2.5 Acceptable daily intake (ADI)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:7.3 Carcinogenicity">7.3 Carcinogenicity</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:7.4 Teratogenicity">7.4 Teratogenicity</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:7.5 Mutagenicity">7.5 Mutagenicity</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:7.6 Interactions">7.6 Interactions</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:8. TOXICOLOGICAL ANALYSES AND BIOMEDICAL INVESTIGATIONS">8. TOXICOLOGICAL ANALYSES AND BIOMEDICAL INVESTIGATIONS</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:8.1 Material sampling plan">8.1 Material sampling plan</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.1.1 Sampling and specimen collection">8.1.1 Sampling and specimen collection</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.1.1 Toxicological analyses">8.1.1.1 Toxicological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.1.2 Biomedical analyses">8.1.1.2 Biomedical analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.1.3 Arterial blood gas analysis">8.1.1.3 Arterial blood gas analysis</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.1.4 Haematological analyses">8.1.1.4 Haematological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.1.5 Other (unspecified) analyses">8.1.1.5 Other (unspecified) analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.1.2 Storage of laboratory samples and specimens">8.1.2 Storage of laboratory samples and specimens</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.2.1 Toxicological analyses">8.1.2.1 Toxicological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.2.2 Biomedical analyses">8.1.2.2 Biomedical analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.2.3 Arterial blood gas analysis">8.1.2.3 Arterial blood gas analysis</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.2.4 Haematological analyses">8.1.2.4 Haematological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.2.5 Other (unspecified) analyses">8.1.2.5 Other (unspecified) analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.1.3 Transport of laboratory samples and specimens">8.1.3 Transport of laboratory samples and specimens</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.3.1 Toxicological analyses">8.1.3.1 Toxicological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.3.2 Biomedical analyses">8.1.3.2 Biomedical analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.3.3 Arterial blood gas analysis">8.1.3.3 Arterial blood gas analysis</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.3.4 Haematological analyses">8.1.3.4 Haematological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.1.3.5 Other (unspecified) analyses">8.1.3.5 Other (unspecified) analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:8.2 Toxicological Analyses and Their Interpretation">8.2 Toxicological Analyses and Their Interpretation</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.2.1 Tests on toxic ingredient(s) of material">8.2.1 Tests on toxic ingredient(s) of material</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.1.1 Simple Qualitative Test(s)">8.2.1.1 Simple Qualitative Test(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.1.2 Advanced Qualitative Confirmation Test(s)">8.2.1.2 Advanced Qualitative Confirmation Test(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.1.3 Simple Quantitative Method(s)">8.2.1.3 Simple Quantitative Method(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.1.4 Advanced Quantitative Method(s)">8.2.1.4 Advanced Quantitative Method(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.2.2 Tests for biological specimens">8.2.2 Tests for biological specimens</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.2.1 Simple Qualitative Test(s)">8.2.2.1 Simple Qualitative Test(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.2.2 Advanced Qualitative Confirmation Test(s)">8.2.2.2 Advanced Qualitative Confirmation Test(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.2.3 Simple Quantitative Method(s)">8.2.2.3 Simple Quantitative Method(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.2.4 Advanced Quantitative Method(s)">8.2.2.4 Advanced Quantitative Method(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.2.2.5 Other Dedicated Method(s)">8.2.2.5 Other Dedicated Method(s)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.2.3 Interpretation of toxicological analyses">8.2.3 Interpretation of toxicological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:8.3 Biomedical investigations and their interpretation">8.3 Biomedical investigations and their interpretation</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.3.1 Biochemical analysis">8.3.1 Biochemical analysis</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.3.1.1 Blood, plasma or serum">8.3.1.1 Blood, plasma or serum</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.3.1.2 Urine">8.3.1.2 Urine</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:8.3.1.3 Other fluids">8.3.1.3 Other fluids</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.3.2 Arterial blood gas analyses">8.3.2 Arterial blood gas analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.3.3 Haematological analyses">8.3.3 Haematological analyses</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:8.3.4 Interpretation of biomedical investigations">8.3.4 Interpretation of biomedical investigations</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:8.4 Other biomedical (diagnostic) investigations and their interpretation">8.4 Other biomedical (diagnostic) investigations and their interpretation</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:8.5 Overall interpretation of all toxicological analyses and toxicological investigations">8.5 Overall interpretation of all toxicological analyses and toxicological investigations</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:8.6 References">8.6 References</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:9. CLINICAL EFFECTS">9. CLINICAL EFFECTS</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:9.1 Acute Poisoning">9.1 Acute Poisoning</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.1.1 Ingestion">9.1.1 Ingestion</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.1.2 Inhalation">9.1.2 Inhalation</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.1.3 Skin exposure">9.1.3 Skin exposure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.1.4 Eye contact">9.1.4 Eye contact</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.1.5 Parenteral exposure">9.1.5 Parenteral exposure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.1.6 Other">9.1.6 Other</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:9.2 Chronic poisoning">9.2 Chronic poisoning</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.2.1 Ingestion">9.2.1 Ingestion</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.2.2 Inhalation">9.2.2 Inhalation</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.2.3 Skin contact">9.2.3 Skin contact</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.2.4 Eye Contact">9.2.4 Eye Contact</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.2.5 Parenteral Exposure">9.2.5 Parenteral Exposure</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.2.6 Other">9.2.6 Other</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:9.3 Course, prognosis, cause of death">9.3 Course, prognosis, cause of death</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:9.4 Systematic description of clinical effects">9.4 Systematic description of clinical effects</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.1 Cardiovascular">9.4.1 Cardiovascular</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.2 Respiratory">9.4.2 Respiratory</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.3 Neurological">9.4.3 Neurological</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.3.1 Central nervous system (CNS)">9.4.3.1 Central nervous system (CNS)</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.3.2 Peripheral nervous system">9.4.3.2 Peripheral nervous system</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.3.3 Autonomic nervous system">9.4.3.3 Autonomic nervous system</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.3.4 Skeletal and smooth muscle">9.4.3.4 Skeletal and smooth muscle</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.4 Gastrointestinal">9.4.4 Gastrointestinal</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.5 Hepatic">9.4.5 Hepatic</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.6 Urinary">9.4.6 Urinary</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.6.1 Renal">9.4.6.1 Renal</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.6.2 Other">9.4.6.2 Other</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.7 Endocrine and reproductive systems">9.4.7 Endocrine and reproductive systems</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.8 Dermatological">9.4.8 Dermatological</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.9 Eye, ear, nose, throat: local effects">9.4.9 Eye, ear, nose, throat: local effects</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.10 Haematological">9.4.10 Haematological</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.11 Immunological">9.4.11 Immunological</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.12 Metabolic">9.4.12 Metabolic</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.12.1 Acid-base disturbances">9.4.12.1 Acid-base disturbances</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.12.2 Fluid and electrolyte disturbances">9.4.12.2 Fluid and electrolyte disturbances</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>         <A HREF="#DivisionTitle:9.4.12.3 Others">9.4.12.3 Others</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.13 Allergic reactions">9.4.13 Allergic reactions</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.14 Other clinical effects">9.4.14 Other clinical effects</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:9.4.15 Special risks">9.4.15 Special risks</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:9.5 Other">9.5 Other</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:9.6 Summary">9.6 Summary</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:10. MANAGEMENT">10. MANAGEMENT</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:10.1 General principles">10.1 General principles</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:10.2 Life supportive procedures and symptomatic/specific treatment">10.2 Life supportive procedures and symptomatic/specific treatment</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:10.3 Decontamination">10.3 Decontamination</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:10.4 Enhanced Elimination">10.4 Enhanced Elimination</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:10.5 Antidote treatment">10.5 Antidote treatment</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:10.5.1 Adults">10.5.1 Adults</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>      <A HREF="#SubSectionTitle:10.5.2 Children">10.5.2 Children</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:10.6 Management discussion">10.6 Management discussion</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:11. ILLUSTRATIVE CASES">11. ILLUSTRATIVE CASES</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:11.1 Case reports from literature">11.1 Case reports from literature</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:12. Additional information">12. Additional information</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:12.1 Specific preventive measures">12.1 Specific preventive measures</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER>   <A HREF="#SectionTitle:12.2 Other">12.2 Other</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:13. REFERENCES">13. REFERENCES</A></TD></TR> <TR HEIGHT=30><TD ALIGN=LEFT VALIGN=CENTER><A HREF="#PartTitle:14. AUTHOR(S), REVIEWER(S), ADDRESS(ES), DATE(S) (INCLUDING UPDATES)">14. AUTHOR(S), REVIEWER(S), ADDRESS(ES), DATE(S) (INCLUDING UPDATES)</A></TD></TR> </TABLE></CENTER> <PRE> POTASSIUM PERMANGANATE International Programme on Chemical Safety Poisons Information Monograph 409 Chemical This monograph contains the following sections: 1. Name; 2. Summary; 9. Clinical effects; 10. Management. <A NAME = "PartTitle:1. NAME"></A>1. NAME <A NAME = "SectionTitle:1.1 Substance"></A>1.1 Substance <PIM1.1>Potassium Permanganate</PIM1.1> <A NAME = "EndSectionTitle:1.1 Substance"></A><A NAME = "SectionTitle:1.2 Group"></A>1.2 Group <PIM1.2>Inorganic Chemical</PIM1.2> <A NAME = "EndSectionTitle:1.2 Group"></A><A NAME = "SectionTitle:1.3 Synonyms"></A>1.3 Synonyms <PIM1.3>Condy's Crystals</PIM1.3>; <PIM1.3>Kalii Permanganas</PIM1.3>; <PIM1.3>Kalium Hypermanganicum</PIM1.3>; <PIM1.3>Kalium Permanganicum</PIM1.3>; <PIM1.3>Nadmanganian Potasu (Polish)</PIM1.3>. <A NAME = "EndSectionTitle:1.3 Synonyms"></A><A NAME = "SectionTitle:1.4 Identification Numbers"></A>1.4 Identification Numbers <A NAME = "SubSectionTitle:1.4.1 CAS number"></A>1.4.1 CAS number <PIM1.4.1><PrimaryCasNo>7722-64-7</PrimaryCasNo></PIM1.4.1> <A NAME = ":1.4.1 CAS number"></A><A NAME = "SubSectionTitle:1.4.2 Other Numbers"></A>1.4.2 Other Numbers <PIM1.4.2>RTECS SD 6475000</PIM1.4.2> <PIM1.4.2>UN NO: 1490</PIM1.4.2> <PIM1.4.2>UN HAZARD CLASS: 5.1</PIM1.4.2> <A NAME = ":1.4.2 Other Numbers"></A><A NAME = "EndSectionTitle:1.4 Identification Numbers"></A><A NAME = "SectionTitle:1.5 Main brand names, main trade names"></A>1.5 Main brand names, main trade names <A NAME = "EndSectionTitle:1.5 Main brand names, main trade names"></A><A NAME = "SectionTitle:1.6 Main manufacturers, main importers"></A>1.6 Main manufacturers, main importers <A NAME = "EndSectionTitle:1.6 Main manufacturers, main importers"></A><A NAME = "EndPartTitle:1. NAME"></A><A NAME = "PartTitle:2. SUMMARY"></A>2. SUMMARY <A NAME = "SectionTitle:2.1 Main risks and target organs"></A>2.1 Main risks and target organs <PIM2.1>Potassium permanganate is an oxidising agent and the crystalline form or concentrated solutions are corrosive. Solutions of greater than 1:5000 strength may cause corrosive burns to the skin and mucous membranes.</PIM2.1> <A NAME = "EndSectionTitle:2.1 Main risks and target organs"></A><A NAME = "SectionTitle:2.2 Summary of clinical effects"></A>2.2 Summary of clinical effects <PIM2.2>Most ingestions of diluted solutions of potassium permanganate used as an antiseptic are benign, and mild irritation is self-limited. Spontaneous emesis and diarrhoea may occur, especially after a large volume ingestion. Exposure to concentrated solutions may cause corrosive burns on the skin and mucous membranes, and oropharyngeal, oesophageal, or gastric injury may occur resulting in ulceration, haemorrhage and perforation. Late complications of upper gastrointestinal ulceration include oesophageal stricture and pyloric stenosis. Glottic oedema and respiratory obstruction have been reported following ingestion of a concentrated solution. Adult respiratory distress syndrome may occur. Renal and hepatic impairment have been reported and haematological involvement was also observed in severe cases (methaemoglobinaemia, haemolysis). Pancreatitis may develop. The causes of death are cardiovascular collapse and hypotensive shock due to massive gastrointestinal haemorrhage and respiratory obstruction. Chronic ingestion may result in neurological effects (parkinsonism) similar to manganism.</PIM2.2> <A NAME = "EndSectionTitle:2.2 Summary of clinical effects"></A><A NAME = "SectionTitle:2.3 Diagnosis"></A>2.3 Diagnosis <PIM2.3>Diagnosis is based on the history of exposure and the presence of mild gastrointestinal upset or frank corrosive injury. Solutions of potassium permanganate are dark purple, and skin and mucous membranes are often characteristically stained. Potassium permanganate tablets are radiopaque thus abdominal radiographs may assist with the diagnosis.</PIM2.3> <A NAME = "EndSectionTitle:2.3 Diagnosis"></A><A NAME = "SectionTitle:2.4 First-aid measures and management principles"></A>2.4 First-aid measures and management principles <PIM2.4>Most ingestions of diluted solutions of potassium permanganate are benign, and mild irritation is self-limited. After ingestion of crystals, tablets or concentrated solutions, monitor the airway for swelling and intubate if necessary. Perform endoscopy (not advancing the endoscope beyond areas of severe esophageal burns) as soon as practicable for the assessment of burns. Do not induce emesis because of the risk of corrosive injury. Activated charcoal and cathartics are not effective and are contraindicated. For significant ingestions consideration may be given to aspirating stomach contents, however the risk of haemorrhage or gastrointestinal perforation could be further compromised by this procedure. If undertaken this should be performed cautiously through a thin, flexible naso-gastric tube. Irrigate the eyes and skin with copious amounts of tepid water. Ocular exposure to a concentrated solution of permanganate may require longer irrigation than exposure to a dilute solution. Remove contaminated clothing. </PIM2.4> <A NAME = "EndSectionTitle:2.4 First-aid measures and management principles"></A><A NAME = "EndPartTitle:2. SUMMARY"></A><A NAME = "PartTitle:3. PHYSICO-CHEMICAL PROPERTIES"></A>3. PHYSICO-CHEMICAL PROPERTIES <A NAME = "SectionTitle:3.1 Origin of the substance"></A>3.1 Origin of the substance <A NAME = "EndSectionTitle:3.1 Origin of the substance"></A><A NAME = "SectionTitle:3.2 Chemical structure"></A>3.2 Chemical structure <A NAME = "EndSectionTitle:3.2 Chemical structure"></A><A NAME = "SectionTitle:3.3 Physical properties"></A>3.3 Physical properties <A NAME = "SubSectionTitle:3.3.1 Colour"></A>3.3.1 Colour <A NAME = ":3.3.1 Colour"></A><A NAME = "SubSectionTitle:3.3.2 State/Form"></A>3.3.2 State/Form <A NAME = ":3.3.2 State/Form"></A><A NAME = "SubSectionTitle:3.3.3 Description"></A>3.3.3 Description <A NAME = ":3.3.3 Description"></A><A NAME = "EndSectionTitle:3.3 Physical properties"></A><A NAME = "SectionTitle:3.4 Hazardous characteristics"></A>3.4 Hazardous characteristics <A NAME = "EndSectionTitle:3.4 Hazardous characteristics"></A><A NAME = "EndPartTitle:3. PHYSICO-CHEMICAL PROPERTIES"></A><A NAME = "PartTitle:4. USES"></A>4. USES <A NAME = "SectionTitle:4.1 Uses"></A>4.1 Uses <A NAME = "SubSectionTitle:4.1.1 Uses"></A>4.1.1 Uses <A NAME = ":4.1.1 Uses"></A><A NAME = "SubSectionTitle:4.1.2 Description"></A>4.1.2 Description <A NAME = ":4.1.2 Description"></A><A NAME = "EndSectionTitle:4.1 Uses"></A><A NAME = "SectionTitle:4.2 High risk circumstance of poisoning"></A>4.2 High risk circumstance of poisoning <A NAME = "EndSectionTitle:4.2 High risk circumstance of poisoning"></A><A NAME = "SectionTitle:4.3 Occupationally exposed populations"></A>4.3 Occupationally exposed populations <A NAME = "EndSectionTitle:4.3 Occupationally exposed populations"></A><A NAME = "EndPartTitle:4. USES"></A><A NAME = "PartTitle:5. ROUTES OF EXPOSURE"></A>5. ROUTES OF EXPOSURE <A NAME = "SectionTitle:5.1 Oral"></A>5.1 Oral <A NAME = "EndSectionTitle:5.1 Oral"></A><A NAME = "SectionTitle:5.2 Inhalation"></A>5.2 Inhalation <A NAME = "EndSectionTitle:5.2 Inhalation"></A><A NAME = "SectionTitle:5.3 Dermal"></A>5.3 Dermal <A NAME = "EndSectionTitle:5.3 Dermal"></A><A NAME = "SectionTitle:5.4 Eye"></A>5.4 Eye <A NAME = "EndSectionTitle:5.4 Eye"></A><A NAME = "SectionTitle:5.5 Parenteral"></A>5.5 Parenteral <A NAME = "EndSectionTitle:5.5 Parenteral"></A><A NAME = "SectionTitle:5.6 Other"></A>5.6 Other <A NAME = "EndSectionTitle:5.6 Other"></A><A NAME = "EndPartTitle:5. ROUTES OF EXPOSURE"></A><A NAME = "PartTitle:6. KINETICS"></A>6. KINETICS <A NAME = "SectionTitle:6.1 Absorption by route of exposure"></A>6.1 Absorption by route of exposure <A NAME = "EndSectionTitle:6.1 Absorption by route of exposure"></A><A NAME = "SectionTitle:6.2 Distribution by route of exposure"></A>6.2 Distribution by route of exposure <A NAME = "EndSectionTitle:6.2 Distribution by route of exposure"></A><A NAME = "SectionTitle:6.3 Biological half-life by route of exposure"></A>6.3 Biological half-life by route of exposure <A NAME = "EndSectionTitle:6.3 Biological half-life by route of exposure"></A><A NAME = "SectionTitle:6.4 Metabolism"></A>6.4 Metabolism <A NAME = "EndSectionTitle:6.4 Metabolism"></A><A NAME = "SectionTitle:6.5 Elimination and excretion"></A>6.5 Elimination and excretion <A NAME = "EndSectionTitle:6.5 Elimination and excretion"></A><A NAME = "EndPartTitle:6. KINETICS"></A><A NAME = "PartTitle:7. TOXICOLOGY"></A>7. TOXICOLOGY <A NAME = "SectionTitle:7.1 Mode of action"></A>7.1 Mode of action <A NAME = "EndSectionTitle:7.1 Mode of action"></A><A NAME = "SectionTitle:7.2 Toxicity"></A>7.2 Toxicity <A NAME = "SubSectionTitle:7.2.1 Human data"></A>7.2.1 Human data <A NAME = "DivisionTitle:7.2.1.1 Adults"></A>7.2.1.1 Adults <A NAME = "EndDivisionTitle:7.2.1.1 Adults"></A><A NAME = "DivisionTitle:7.2.1.2 Children"></A>7.2.1.2 Children <A NAME = "EndDivisionTitle:7.2.1.2 Children"></A><A NAME = ":7.2.1 Human data"></A><A NAME = "SubSectionTitle:7.2.2 Relevant animal data"></A>7.2.2 Relevant animal data <A NAME = ":7.2.2 Relevant animal data"></A><A NAME = "SubSectionTitle:7.2.3 Relevant in vitro data"></A>7.2.3 Relevant in vitro data <A NAME = ":7.2.3 Relevant in vitro data"></A><A NAME = "SubSectionTitle:7.2.4 Workplace standards"></A>7.2.4 Workplace standards <A NAME = ":7.2.4 Workplace standards"></A><A NAME = "SubSectionTitle:7.2.5 Acceptable daily intake (ADI)"></A>7.2.5 Acceptable daily intake (ADI) <A NAME = ":7.2.5 Acceptable daily intake (ADI)"></A><A NAME = "EndSectionTitle:7.2 Toxicity"></A><A NAME = "SectionTitle:7.3 Carcinogenicity"></A>7.3 Carcinogenicity <A NAME = "EndSectionTitle:7.3 Carcinogenicity"></A><A NAME = "SectionTitle:7.4 Teratogenicity"></A>7.4 Teratogenicity <A NAME = "EndSectionTitle:7.4 Teratogenicity"></A><A NAME = "SectionTitle:7.5 Mutagenicity"></A>7.5 Mutagenicity <A NAME = "EndSectionTitle:7.5 Mutagenicity"></A><A NAME = "SectionTitle:7.6 Interactions"></A>7.6 Interactions <A NAME = "EndSectionTitle:7.6 Interactions"></A><A NAME = "EndPartTitle:7. TOXICOLOGY"></A><A NAME = "PartTitle:8. TOXICOLOGICAL ANALYSES AND BIOMEDICAL INVESTIGATIONS"></A>8. TOXICOLOGICAL ANALYSES AND BIOMEDICAL INVESTIGATIONS <A NAME = "SectionTitle:8.1 Material sampling plan"></A>8.1 Material sampling plan <A NAME = "SubSectionTitle:8.1.1 Sampling and specimen collection"></A>8.1.1 Sampling and specimen collection <A NAME = "DivisionTitle:8.1.1.1 Toxicological analyses"></A>8.1.1.1 Toxicological analyses <A NAME = "EndDivisionTitle:8.1.1.1 Toxicological analyses"></A><A NAME = "DivisionTitle:8.1.1.2 Biomedical analyses"></A>8.1.1.2 Biomedical analyses <A NAME = "EndDivisionTitle:8.1.1.2 Biomedical analyses"></A><A NAME = "DivisionTitle:8.1.1.3 Arterial blood gas analysis"></A>8.1.1.3 Arterial blood gas analysis <A NAME = "EndDivisionTitle:8.1.1.3 Arterial blood gas analysis"></A><A NAME = "DivisionTitle:8.1.1.4 Haematological analyses"></A>8.1.1.4 Haematological analyses <A NAME = "EndDivisionTitle:8.1.1.4 Haematological analyses"></A><A NAME = "DivisionTitle:8.1.1.5 Other (unspecified) analyses"></A>8.1.1.5 Other (unspecified) analyses <A NAME = "EndDivisionTitle:8.1.1.5 Other (unspecified) analyses"></A><A NAME = ":8.1.1 Sampling and specimen collection"></A><A NAME = "SubSectionTitle:8.1.2 Storage of laboratory samples and specimens"></A>8.1.2 Storage of laboratory samples and specimens <A NAME = "DivisionTitle:8.1.2.1 Toxicological analyses"></A>8.1.2.1 Toxicological analyses <A NAME = "EndDivisionTitle:8.1.2.1 Toxicological analyses"></A><A NAME = "DivisionTitle:8.1.2.2 Biomedical analyses"></A>8.1.2.2 Biomedical analyses <A NAME = "EndDivisionTitle:8.1.2.2 Biomedical analyses"></A><A NAME = "DivisionTitle:8.1.2.3 Arterial blood gas analysis"></A>8.1.2.3 Arterial blood gas analysis <A NAME = "EndDivisionTitle:8.1.2.3 Arterial blood gas analysis"></A><A NAME = "DivisionTitle:8.1.2.4 Haematological analyses"></A>8.1.2.4 Haematological analyses <A NAME = "EndDivisionTitle:8.1.2.4 Haematological analyses"></A><A NAME = "DivisionTitle:8.1.2.5 Other (unspecified) analyses"></A>8.1.2.5 Other (unspecified) analyses <A NAME = "EndDivisionTitle:8.1.2.5 Other (unspecified) analyses"></A><A NAME = ":8.1.2 Storage of laboratory samples and specimens"></A><A NAME = "SubSectionTitle:8.1.3 Transport of laboratory samples and specimens"></A>8.1.3 Transport of laboratory samples and specimens <A NAME = "DivisionTitle:8.1.3.1 Toxicological analyses"></A>8.1.3.1 Toxicological analyses <A NAME = "EndDivisionTitle:8.1.3.1 Toxicological analyses"></A><A NAME = "DivisionTitle:8.1.3.2 Biomedical analyses"></A>8.1.3.2 Biomedical analyses <A NAME = "EndDivisionTitle:8.1.3.2 Biomedical analyses"></A><A NAME = "DivisionTitle:8.1.3.3 Arterial blood gas analysis"></A>8.1.3.3 Arterial blood gas analysis <A NAME = "EndDivisionTitle:8.1.3.3 Arterial blood gas analysis"></A><A NAME = "DivisionTitle:8.1.3.4 Haematological analyses"></A>8.1.3.4 Haematological analyses <A NAME = "EndDivisionTitle:8.1.3.4 Haematological analyses"></A><A NAME = "DivisionTitle:8.1.3.5 Other (unspecified) analyses"></A>8.1.3.5 Other (unspecified) analyses <A NAME = "EndDivisionTitle:8.1.3.5 Other (unspecified) analyses"></A><A NAME = ":8.1.3 Transport of laboratory samples and specimens"></A><A NAME = "EndSectionTitle:8.1 Material sampling plan"></A><A NAME = "SectionTitle:8.2 Toxicological Analyses and Their Interpretation"></A>8.2 Toxicological Analyses and Their Interpretation <A NAME = "SubSectionTitle:8.2.1 Tests on toxic ingredient(s) of material"></A>8.2.1 Tests on toxic ingredient(s) of material <A NAME = "DivisionTitle:8.2.1.1 Simple Qualitative Test(s)"></A>8.2.1.1 Simple Qualitative Test(s) <A NAME = "EndDivisionTitle:8.2.1.1 Simple Qualitative Test(s)"></A><A NAME = "DivisionTitle:8.2.1.2 Advanced Qualitative Confirmation Test(s)"></A>8.2.1.2 Advanced Qualitative Confirmation Test(s) <A NAME = "EndDivisionTitle:8.2.1.2 Advanced Qualitative Confirmation Test(s)"></A><A NAME = "DivisionTitle:8.2.1.3 Simple Quantitative Method(s)"></A>8.2.1.3 Simple Quantitative Method(s) <A NAME = "EndDivisionTitle:8.2.1.3 Simple Quantitative Method(s)"></A><A NAME = "DivisionTitle:8.2.1.4 Advanced Quantitative Method(s)"></A>8.2.1.4 Advanced Quantitative Method(s) <A NAME = "EndDivisionTitle:8.2.1.4 Advanced Quantitative Method(s)"></A><A NAME = ":8.2.1 Tests on toxic ingredient(s) of material"></A><A NAME = "SubSectionTitle:8.2.2 Tests for biological specimens"></A>8.2.2 Tests for biological specimens <A NAME = "DivisionTitle:8.2.2.1 Simple Qualitative Test(s)"></A>8.2.2.1 Simple Qualitative Test(s) <A NAME = "EndDivisionTitle:8.2.2.1 Simple Qualitative Test(s)"></A><A NAME = "DivisionTitle:8.2.2.2 Advanced Qualitative Confirmation Test(s)"></A>8.2.2.2 Advanced Qualitative Confirmation Test(s) <A NAME = "EndDivisionTitle:8.2.2.2 Advanced Qualitative Confirmation Test(s)"></A><A NAME = "DivisionTitle:8.2.2.3 Simple Quantitative Method(s)"></A>8.2.2.3 Simple Quantitative Method(s) <A NAME = "EndDivisionTitle:8.2.2.3 Simple Quantitative Method(s)"></A><A NAME = "DivisionTitle:8.2.2.4 Advanced Quantitative Method(s)"></A>8.2.2.4 Advanced Quantitative Method(s) <A NAME = "EndDivisionTitle:8.2.2.4 Advanced Quantitative Method(s)"></A><A NAME = "DivisionTitle:8.2.2.5 Other Dedicated Method(s)"></A>8.2.2.5 Other Dedicated Method(s) <A NAME = "EndDivisionTitle:8.2.2.5 Other Dedicated Method(s)"></A><A NAME = ":8.2.2 Tests for biological specimens"></A><A NAME = "SubSectionTitle:8.2.3 Interpretation of toxicological analyses"></A>8.2.3 Interpretation of toxicological analyses <A NAME = ":8.2.3 Interpretation of toxicological analyses"></A><A NAME = "EndSectionTitle:8.2 Toxicological Analyses and Their Interpretation"></A><A NAME = "SectionTitle:8.3 Biomedical investigations and their interpretation"></A>8.3 Biomedical investigations and their interpretation <A NAME = "SubSectionTitle:8.3.1 Biochemical analysis"></A>8.3.1 Biochemical analysis <A NAME = "DivisionTitle:8.3.1.1 Blood, plasma or serum"></A>8.3.1.1 Blood, plasma or serum <A NAME = "EndDivisionTitle:8.3.1.1 Blood, plasma or serum"></A><A NAME = "DivisionTitle:8.3.1.2 Urine"></A>8.3.1.2 Urine <A NAME = "EndDivisionTitle:8.3.1.2 Urine"></A><A NAME = "DivisionTitle:8.3.1.3 Other fluids"></A>8.3.1.3 Other fluids <A NAME = "EndDivisionTitle:8.3.1.3 Other fluids"></A><A NAME = ":8.3.1 Biochemical analysis"></A><A NAME = "SubSectionTitle:8.3.2 Arterial blood gas analyses"></A>8.3.2 Arterial blood gas analyses <A NAME = ":8.3.2 Arterial blood gas analyses"></A><A NAME = "SubSectionTitle:8.3.3 Haematological analyses"></A>8.3.3 Haematological analyses <A NAME = ":8.3.3 Haematological analyses"></A><A NAME = "SubSectionTitle:8.3.4 Interpretation of biomedical investigations"></A>8.3.4 Interpretation of biomedical investigations <A NAME = ":8.3.4 Interpretation of biomedical investigations"></A><A NAME = "EndSectionTitle:8.3 Biomedical investigations and their interpretation"></A><A NAME = "SectionTitle:8.4 Other biomedical (diagnostic) investigations and their interpretation"></A>8.4 Other biomedical (diagnostic) investigations and their interpretation <A NAME = "EndSectionTitle:8.4 Other biomedical (diagnostic) investigations and their interpretation"></A><A NAME = "SectionTitle:8.5 Overall interpretation of all toxicological analyses and toxicological investigations"></A>8.5 Overall interpretation of all toxicological analyses and toxicological investigations <A NAME = "EndSectionTitle:8.5 Overall interpretation of all toxicological analyses and toxicological investigations"></A><A NAME = "SectionTitle:8.6 References"></A>8.6 References <A NAME = "EndSectionTitle:8.6 References"></A><A NAME = "EndPartTitle:8. TOXICOLOGICAL ANALYSES AND BIOMEDICAL INVESTIGATIONS"></A><A NAME = "PartTitle:9. CLINICAL EFFECTS"></A>9. CLINICAL EFFECTS <A NAME = "SectionTitle:9.1 Acute Poisoning"></A>9.1 Acute Poisoning <A NAME = "SubSectionTitle:9.1.1 Ingestion"></A>9.1.1 Ingestion <PIM9.1.1>Most ingestions of diluted solutions of potassium permanganate used as an antiseptic are benign, and mild irritation is self-limited. Spontaneous emesis and diarrhoea may occur, especially after a large volume ingestion. Exposure to concentrated solutions may cause corrosive burns on the skin and mucous membranes, and oropharyngeal, oesophageal, or gastric injury may occur. Glottic oedema has been reported following ingestion of a concentrated solution (Olsen, 1994). Permanganate may also cause methaemoglobinemia due to its oxidising properties (Mahomedy et al., 1975).</PIM9.1.1> <A NAME = ":9.1.1 Ingestion"></A><A NAME = "SubSectionTitle:9.1.2 Inhalation"></A>9.1.2 Inhalation <PIM9.1.2>No data available.</PIM9.1.2> <A NAME = ":9.1.2 Inhalation"></A><A NAME = "SubSectionTitle:9.1.3 Skin exposure"></A>9.1.3 Skin exposure <PIM9.1.3>Exposure to concentrated solutions may cause corrosive burns on the skin and mucous membranes. Solutions of potassium permanganate are dark purple, and skin and mucous membranes are often characteristically stained purple brown (Olsen 1994).</PIM9.1.3> <A NAME = ":9.1.3 Skin exposure"></A><A NAME = "SubSectionTitle:9.1.4 Eye contact"></A>9.1.4 Eye contact <PIM9.1.4>Eye exposure can cause corneal and conjunctival burns (Michaels & Zugsmith, 1973).</PIM9.1.4> <A NAME = ":9.1.4 Eye contact"></A><A NAME = "SubSectionTitle:9.1.5 Parenteral exposure"></A>9.1.5 Parenteral exposure <PIM9.1.5>No data available</PIM9.1.5> <A NAME = ":9.1.5 Parenteral exposure"></A><A NAME = "SubSectionTitle:9.1.6 Other"></A>9.1.6 Other <PIM9.1.6>Vaginal exposure (used as an abortifacient) can cause vaginal or cervical burns and erosions (Vago, 1969; Le Coz et al., 1968).</PIM9.1.6> <A NAME = ":9.1.6 Other"></A><A NAME = "EndSectionTitle:9.1 Acute Poisoning"></A><A NAME = "SectionTitle:9.2 Chronic poisoning"></A>9.2 Chronic poisoning <A NAME = "SubSectionTitle:9.2.1 Ingestion"></A>9.2.1 Ingestion <PIM9.2.1>Chronic ingestion may result in neurological effects (parkinsonism) similar to manganism (Holzgraefe et al., 1986).</PIM9.2.1> <A NAME = ":9.2.1 Ingestion"></A><A NAME = "SubSectionTitle:9.2.2 Inhalation"></A>9.2.2 Inhalation <PIM9.2.2>No data available.</PIM9.2.2> <A NAME = ":9.2.2 Inhalation"></A><A NAME = "SubSectionTitle:9.2.3 Skin contact"></A>9.2.3 Skin contact <PIM9.2.3>No data available.</PIM9.2.3> <A NAME = ":9.2.3 Skin contact"></A><A NAME = "SubSectionTitle:9.2.4 Eye Contact"></A>9.2.4 Eye Contact <PIM9.2.4>No data available.</PIM9.2.4> <A NAME = ":9.2.4 Eye Contact"></A><A NAME = "SubSectionTitle:9.2.5 Parenteral Exposure"></A>9.2.5 Parenteral Exposure <PIM9.2.5>No data available.</PIM9.2.5> <A NAME = ":9.2.5 Parenteral Exposure"></A><A NAME = "SubSectionTitle:9.2.6 Other"></A>9.2.6 Other <PIM9.2.6>No data available.</PIM9.2.6> <A NAME = ":9.2.6 Other"></A><A NAME = "EndSectionTitle:9.2 Chronic poisoning"></A><A NAME = "SectionTitle:9.3 Course, prognosis, cause of death"></A>9.3 Course, prognosis, cause of death <PIM9.3>Acute life threatening, laryngeal oedema is the most immediate concern after the ingestion of potassium permanganate. Ulceration of the mouth, oesophagus and, to a lesser extent, stomach can occur secondary to the caustic action of potassium permanganate. Late complications (several days post exposure) of upper gastrointestinal ulceration including oesophageal stricture and pyloric stenosis may occur. Renal, hepatic and haematological (methaemoglobinaemia, haemolysis) involvement has been reported. The causes of death are cardiovascular collapse and hypotensive shock due to massive gastrointestinal haemorrhage and respiratory obstruction (Middleton et al., 1990; Southwood et al., 1987).</PIM9.3> <A NAME = "EndSectionTitle:9.3 Course, prognosis, cause of death"></A><A NAME = "SectionTitle:9.4 Systematic description of clinical effects"></A>9.4 Systematic description of clinical effects <A NAME = "SubSectionTitle:9.4.1 Cardiovascular"></A>9.4.1 Cardiovascular <PIM9.4.1>Transient hypertension and tachycardia may develop soon after ingestion. Profound hypotension and circulatory collapse has been reported in severe cases of ingestion (Middleton et al., 1990; Ong et al., 1997; Young et al., 1996).</PIM9.4.1> <A NAME = ":9.4.1 Cardiovascular"></A><A NAME = "SubSectionTitle:9.4.2 Respiratory"></A>9.4.2 Respiratory <PIM9.4.2>Upper airway burns and oedema and stridor have been reported after ingestion of permanganate (Ong et al., 1997; Young et al., 1996; Southwood et al., 1987). Adult respiratory distress syndrome has also been described following ingestion (Middleton et al., 1990).</PIM9.4.2> <A NAME = ":9.4.2 Respiratory"></A><A NAME = "SubSectionTitle:9.4.3 Neurological"></A>9.4.3 Neurological <A NAME = "DivisionTitle:9.4.3.1 Central nervous system (CNS)"></A>9.4.3.1 Central nervous system (CNS) <PIM9.4.3.1>Impairment of the extrapyramidal system: dysarthria, resting tremor, shortening of gait (Holzgraefe et al., 1986).</PIM9.4.3.1> <A NAME = "EndDivisionTitle:9.4.3.1 Central nervous system (CNS)"></A><A NAME = "DivisionTitle:9.4.3.2 Peripheral nervous system"></A>9.4.3.2 Peripheral nervous system <PIM9.4.3.2>Paraesthesias and hypoesthesias have been reported in a case of a 66-year-old man who was mistakenly administered potassium permanaganate (125 mL of an 8% solution) over a period of 4 weeks (Holzgraefe et al., 1986).</PIM9.4.3.2> <A NAME = "EndDivisionTitle:9.4.3.2 Peripheral nervous system"></A><A NAME = "DivisionTitle:9.4.3.3 Autonomic nervous system"></A>9.4.3.3 Autonomic nervous system <PIM9.4.3.3>Increased sweating (Holzgraefe et al., 1986).</PIM9.4.3.3> <A NAME = "EndDivisionTitle:9.4.3.3 Autonomic nervous system"></A><A NAME = "DivisionTitle:9.4.3.4 Skeletal and smooth muscle"></A>9.4.3.4 Skeletal and smooth muscle <PIM9.4.3.4>Tremor and widespread muscle fasiculations have been reported in a case involving a 66-year-old male who was mistakenly administered 10 g of potassium permanganate over 4 weeks. Nine months post exposure he had developed evidence of a Parkinson syndrome (Holzgraefe et al., 1986).</PIM9.4.3.4> <A NAME = "EndDivisionTitle:9.4.3.4 Skeletal and smooth muscle"></A><A NAME = ":9.4.3 Neurological"></A><A NAME = "SubSectionTitle:9.4.4 Gastrointestinal"></A>9.4.4 Gastrointestinal <PIM9.4.4>The gastrointestinal tract is invariably damaged by the caustic action of potassium permanganate. Spontaneous emesis and diarrhoea may occur, especially after a large volume ingestion. Ulceration, perforation and haemorrhage after ingestion of crystals, or tablets, or concentrated solutions occasionally occur. The mucous membrane is brown-black stained which may mimic necrosis. Late complications of upper gastrointestinal ulceration include oesophageal stricture and pyloric stenosis (Southwood et al., 1987; Middleton et al., 1990).</PIM9.4.4> <A NAME = ":9.4.4 Gastrointestinal"></A><A NAME = "SubSectionTitle:9.4.5 Hepatic"></A>9.4.5 Hepatic <PIM9.4.5>Abnormalities of liver function (elevated AST, bilirubin) suggesting hepatocellular damage have been reported following ingestion of permanganate (Middleton et al., 1990). In severe cases fulminant hepatic failure and necrosis may occur (Ong et al., 1997).</PIM9.4.5> <A NAME = ":9.4.5 Hepatic"></A><A NAME = "SubSectionTitle:9.4.6 Urinary"></A>9.4.6 Urinary <A NAME = "DivisionTitle:9.4.6.1 Renal"></A>9.4.6.1 Renal <PIM9.4.6.1>Acute renal failure has been reported to occur several days after the ingestion of permanganate (Ong et al., 1997; Young et al., 1996).</PIM9.4.6.1> <A NAME = "EndDivisionTitle:9.4.6.1 Renal"></A><A NAME = "DivisionTitle:9.4.6.2 Other"></A>9.4.6.2 Other <PIM9.4.6.2>Proteinuria was reported to develop in a 68-year-old male who injected about 7 g of an aqueous solution of potassium permanganate into his intercostal space (Lustig et al., 1982).</PIM9.4.6.2> <A NAME = "EndDivisionTitle:9.4.6.2 Other"></A><A NAME = ":9.4.6 Urinary"></A><A NAME = "SubSectionTitle:9.4.7 Endocrine and reproductive systems"></A>9.4.7 Endocrine and reproductive systems <PIM9.4.7>Hyperglycaemia and elevated serum amylase levels has been reported in a patient who developed severe haemorrhagic pancreatitis after ingesting 20 grams of permanganate (Middleton et al., 1990). Potassium Permanganate has been used as an abortifacient via the oral route, causing fetal death (Kochhar et al., 1986) or by direct application to the vagina which usually results in vaginal bleeding and perforation and not abortion (Verelli, 1965).</PIM9.4.7> <A NAME = ":9.4.7 Endocrine and reproductive systems"></A><A NAME = "SubSectionTitle:9.4.8 Dermatological"></A>9.4.8 Dermatological <PIM9.4.8>Exposure to concentrated solutions may cause corrosive burns on the skin. Solutions of potassium permanganate are dark purple, and skin and mucous membranes are often characteristically stained purple brown (Olsen, 1994).</PIM9.4.8> <A NAME = ":9.4.8 Dermatological"></A><A NAME = "SubSectionTitle:9.4.9 Eye, ear, nose, throat: local effects"></A>9.4.9 Eye, ear, nose, throat: local effects <PIM9.4.9>Decreased visual acuity, corneal clouding, subconjunctival haemorrhages and brownish conjunctival discolouration were described in a 22-year-old male subject who sustained potassium permanganate burns to his eyes (Michaels & Zugsmith, 1973). Occasional diplopia was reported in a chronic case of permanganate administration (Holzgraefe et al., 1986).</PIM9.4.9> <A NAME = ":9.4.9 Eye, ear, nose, throat: local effects"></A><A NAME = "SubSectionTitle:9.4.10 Haematological"></A>9.4.10 Haematological <PIM9.4.10>Methaemoglobinemia has been reported to occur following the ingestion of large doses of potassium permanganate due to its oxidising properties (Mahomedy et al., 1975). Disseminated intravascular coagulation has been described following a large ingestion of potassium permanganate (Young et al., 1996).</PIM9.4.10> <A NAME = ":9.4.10 Haematological"></A><A NAME = "SubSectionTitle:9.4.11 Immunological"></A>9.4.11 Immunological <PIM9.4.11>No data available</PIM9.4.11> <A NAME = ":9.4.11 Immunological"></A><A NAME = "SubSectionTitle:9.4.12 Metabolic"></A>9.4.12 Metabolic <A NAME = "DivisionTitle:9.4.12.1 Acid-base disturbances"></A>9.4.12.1 Acid-base disturbances <PIM9.4.12.1>No data available.</PIM9.4.12.1> <A NAME = "EndDivisionTitle:9.4.12.1 Acid-base disturbances"></A><A NAME = "DivisionTitle:9.4.12.2 Fluid and electrolyte disturbances"></A>9.4.12.2 Fluid and electrolyte disturbances <PIM9.4.12.2>No data available.</PIM9.4.12.2> <A NAME = "EndDivisionTitle:9.4.12.2 Fluid and electrolyte disturbances"></A><A NAME = "DivisionTitle:9.4.12.3 Others"></A>9.4.12.3 Others <PIM9.4.12.3>No data available.</PIM9.4.12.3> <A NAME = "EndDivisionTitle:9.4.12.3 Others"></A><A NAME = ":9.4.12 Metabolic"></A><A NAME = "SubSectionTitle:9.4.13 Allergic reactions"></A>9.4.13 Allergic reactions <PIM9.4.13>No data available.</PIM9.4.13> <A NAME = ":9.4.13 Allergic reactions"></A><A NAME = "SubSectionTitle:9.4.14 Other clinical effects"></A>9.4.14 Other clinical effects <PIM9.4.14>No data available.</PIM9.4.14> <A NAME = ":9.4.14 Other clinical effects"></A><A NAME = "SubSectionTitle:9.4.15 Special risks"></A>9.4.15 Special risks <PIM9.4.15>Potassium Permanganate has been used as an abortifacient via the oral route, causing fetal death (Kochhar et al., 1986) or by direct application to the vagina which usually results in vaginal or cervical burns and erosions, extensive bleeding, shock and not abortion (Verelli, 1965).</PIM9.4.15> <A NAME = ":9.4.15 Special risks"></A><A NAME = "EndSectionTitle:9.4 Systematic description of clinical effects"></A><A NAME = "SectionTitle:9.5 Other"></A>9.5 Other <PIM9.5>No data available.</PIM9.5> <A NAME = "EndSectionTitle:9.5 Other"></A><A NAME = "SectionTitle:9.6 Summary"></A>9.6 Summary <A NAME = "EndSectionTitle:9.6 Summary"></A><A NAME = "EndPartTitle:9. CLINICAL EFFECTS"></A><A NAME = "PartTitle:10. MANAGEMENT"></A>10. MANAGEMENT <A NAME = "SectionTitle:10.1 General principles"></A>10.1 General principles <PIM10.1>Treatment is symptomatic and supportive. There is no specific antidote. Most ingestions are benign, and mild irritation is self-limited and only clinical observation and symptomatic treatment are necessary. After ingestion of crystals, tablets or concentrated solutions, monitor the airway for swelling and intubate if necessary. Perform endoscopy (not advancing the endoscope beyond areas of severe oesophageal burns) as soon as practicable for the assessment of burns. Do not induce emesis because of the risk of corrosive injury. For significant ingestions consideration may be given to aspirating stomach contents, however the risk of haemorrhage or gastrointestinal perforation could be further compromised by this procedure. If undertaken this should be performed cautiously through a thin, flexible naso-gastric tube. Activated charcoal and cathartics are not effective and are contraindicated. (EAPCCT and AACT, 1997; Southwood et al., 1987; Olsen, 1994).<NL> <NL> Irrigate the eyes and skin with copious amounts of tepid water. Ocular exposure to a concentrated solution of permanganate may require longer irrigation than exposure to a dilute solution. Remove contaminated clothing (Southwood et al., 1987; Olsen, 1994).</PIM10.1> <A NAME = "EndSectionTitle:10.1 General principles"></A><A NAME = "SectionTitle:10.2 Life supportive procedures and symptomatic/specific treatment"></A>10.2 Life supportive procedures and symptomatic/specific treatment <PIM10.2>After ingestion of concentrated solutions, monitor the airway for swelling and intubate or perform emergency tracheostomy if necessary.<NL> <NL> Support respiratory and cardiovascular function. Early oesophagoscopy should be performed to assess the severity of the burns, although these may be obscured by the brown-black discolouration of the mucous membrane, which may mimic necrosis. Care should be taken not to pass the endoscope beyond the first severe burn as perforation is a possibility. Monitor liver and renal function tests in cases of significant exposure. Monitor INR or PT and platelet counts in subjects with severe toxicity. Monitor arterial blood gases in patients with severe respiratory symptoms (Southwood et al., 1987; Olsen, 1994). Treat methaemoglobinaemia if it develops.</PIM10.2> <A NAME = "EndSectionTitle:10.2 Life supportive procedures and symptomatic/specific treatment"></A><A NAME = "SectionTitle:10.3 Decontamination"></A>10.3 Decontamination <PIM10.3>Do not induce emesis because of the risk of corrosive injury. Activated charcoal and cathartics are not effective and are contraindicated. For significant ingestions consideration may be given to aspirating stomach contents, however the risk of haemorrhage or gastrointestinal perforation could be further compromised by this procedure. If undertaken this should be performed cautiously through a thin, flexible naso-gastric tube (Southwood et al 1987, Olsen 1994).<NL> <NL> Remove and discard contaminated clothing. Wash skin with copious amounts of water.<NL> <NL> Irrigate exposed eyes with copious amounts of water or saline. Irrigation should be continued until the eyes have been thoroughly examined for particulate matter and returned to neutrality. Ocular exposure to a concentrated solution of permanganate may require longer irrigation than exposure to a dilute solution.</PIM10.3> <A NAME = "EndSectionTitle:10.3 Decontamination"></A><A NAME = "SectionTitle:10.4 Enhanced Elimination"></A>10.4 Enhanced Elimination <PIM10.4>No data available</PIM10.4> <A NAME = "EndSectionTitle:10.4 Enhanced Elimination"></A><A NAME = "SectionTitle:10.5 Antidote treatment"></A>10.5 Antidote treatment <A NAME = "SubSectionTitle:10.5.1 Adults"></A>10.5.1 Adults <PIM10.5.1>No antidote is available</PIM10.5.1> <A NAME = ":10.5.1 Adults"></A><A NAME = "SubSectionTitle:10.5.2 Children"></A>10.5.2 Children <PIM10.5.2>No antidote is available</PIM10.5.2> <A NAME = ":10.5.2 Children"></A><A NAME = "EndSectionTitle:10.5 Antidote treatment"></A><A NAME = "SectionTitle:10.6 Management discussion"></A>10.6 Management discussion <PIM10.6>Corticosteroids are not indicated. In the past they were used in the hope of reducing the incidence of oesophageal scarring but have since proved ineffective. Moreover, steroids may be harmful in the patient with perforation by masking early signs of inflammation and inhibiting resistance to infection (Olsen, 1994).<NL> <NL> Antibiotics may be considered in the case of severe burns and is recommended for suspected secondary infection. The use of antibiotics for prophylaxis is controversial.<NL> <NL> Following ingestion of potassium permanganate the use of histamine II antagonists has been considered but efficacy has not been fully evaluated.<NL> <NL> N-acetylcysteine has been used in the treatment of potassium permanganate induced hepatotoxicity, but efficacy has not been established (Young et al., 1996).</PIM10.6> <A NAME = "EndSectionTitle:10.6 Management discussion"></A><A NAME = "EndPartTitle:10. MANAGEMENT"></A><A NAME = "PartTitle:11. ILLUSTRATIVE CASES"></A>11. ILLUSTRATIVE CASES <A NAME = "SectionTitle:11.1 Case reports from literature"></A>11.1 Case reports from literature <A NAME = "EndSectionTitle:11.1 Case reports from literature"></A><A NAME = "EndPartTitle:11. ILLUSTRATIVE CASES"></A><A NAME = "PartTitle:12. Additional information"></A>12. Additional information <A NAME = "SectionTitle:12.1 Specific preventive measures"></A>12.1 Specific preventive measures <A NAME = "EndSectionTitle:12.1 Specific preventive measures"></A><A NAME = "SectionTitle:12.2 Other"></A>12.2 Other <A NAME = "EndSectionTitle:12.2 Other"></A><A NAME = "EndPartTitle:12. Additional information"></A><A NAME = "PartTitle:13. REFERENCES"></A>13. REFERENCES <PIM13.>EAPCCT and ACCT (1997) Position statements on gastrointestinal decontamination. Clin Toxicol, 35(7)<NL> <NL> Holzgraefe M, Poser W, Kijewski H Beuche W (1986) Chronic enteral poisoning caused by potassium permanganate: a case report. J Toxicol Clin Toxicol, 24(3): 235-244<NL> <NL> Kochhar R, Das K, Mehta SK (1986) potassium permanganate induced oesophageal stricture. Human Toxicol, 5: 393-394<NL> <NL> Le Coz A, Mazerolles J and Delafargue M (1968) Attempt at abortion with potassium permanganate tablets. Bulletin de la F閐閞ation des Soci閠閟 de Gyn閏ologie et d'Obst閠rique de Langue Fran鏰ise, 20(2): 190-191<NL> <NL> Lustig S, Pitlik SD & Rosenfeld JB (1982) Liver damage in acute self-induced hypermanganemia. Arch Intern Med, 142(2): 405-406.<NL> <NL> Mahomedy MC, Mahomedy YH, Canham PA, Downing JW and Jeal DE (1975) Methaemoglobinaemia following treatment dispensed by witch doctors. Two cases of potassium permanganate poisoning Anaesthesia, 30(2): 190-193<NL> <NL> Michaels DD & Zugsmith GS (1973) Potassium permanganate burn of the eye. Eye, Ear, Nose & Throat Monthly, 52(3): 42-43<NL> <NL> Middleton SJ, Jacyna M, McClaren D, Robinson R and Thomas HC (1990) Haemorrhagic pancreatitis - a cause of death in severe potassium permanganate poisoning. Postgrad Med J, 66: 657-658<NL> <NL> Ong KL, Tan TH & Cheung WL (1997) Potassium permanganate poisoning - a rare cause of fatal self poisoning. J Accid Emerg Med, 14(1): 43-45<NL> <NL> Olsen KR (1999) Poisoning and Drug Overdose, 3rd edition, Appleton & Lange, Norwalk, Connecticut<NL> <NL> Southwood T, Lamb CM & Freeman J (1987) Ingestion of potassium permanganate crystals by a three-year-old boy. Med J Aust, 146: 639-640<NL> <NL> Vago O (1969) Toxic and caustic complications through use of so-called abortifacients. Zeitschrift fur Geburtshilfe und Perinatologie, 170(3): 272-277<NL> <NL> Verelli D (1965) Osservazioni e considerazioni sull'applicazione di compresse di permanganato in vagina a scopo abortivo. Quaderni di Clinica Ostetrica e Ginecologica, 20(11): 617-643<NL> <NL> Young RJ, Critchley JAJH, Young KK, Freebairn RC, Reynolds AP,Lolin YI (1996) Fatal acute hepatorenal failure following potassium permanganate ingestion. Human Exp Toxicol, 15(3): 259-261</PIM13.> <A NAME = "EndPartTitle:13. REFERENCES"></A><A NAME = "PartTitle:14. AUTHOR(S), REVIEWER(S), ADDRESS(ES), DATE(S) (INCLUDING UPDATES)"></A>14. AUTHOR(S), REVIEWER(S), ADDRESS(ES), DATE(S) (INCLUDING UPDATES) <PIM14.>Authors: Dr W.A. Temple<NL> Dr N.A. Smith<NL> National Toxicology Group<NL> Dunedin<NL> New Zealand<NL> <NL> Date: August 1998<NL> <NL> Peer<NL> Review: INTOX PIM E-mail Group 1<NL> (members: Dr N. Besbelli, Dr D. Cobaugh, Dr L. Fruchtengarten, Dr B. Groszek, Dr K. Hartigan-Go, Dr M.O. Rambourg)</PIM14.> <A NAME = "EndPartTitle:14. AUTHOR(S), REVIEWER(S), ADDRESS(ES), DATE(S) (INCLUDING UPDATES)"></A> </PRE> <script src="/scripts/google_analytics.js" type="text/javascript"></script> </BODY> <PRE> </PRE> <PRE> See Also: <A HREF="../../eintro/eintro/abreviat.htm">Toxicological Abbreviations</A> </PRE> </HTML>

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Potassium permangante (PIM 409)