Study on outcome of N-acetylcysteine in rodenticide poisoning cases in a rural tertiary care teaching hospital

K. Padmavathi, R. Rajalakshmi, G. Dhivya, P. Kamalavarshini, R. Umarani


Background: Rodenticide is one of the pesticides and heterogeneous substances used to kill rats. Rodenticide poisoning is the major health problem in Asian countries, particularly mode of self-poisoning, prevalent in India. It causes hepatotoxicity and no antidote has been found. N-acetylcysteine (NAC) is a powerful antioxidant and used in the treatment of acetaminophen-induced hepatotoxicity.  The aim of the study is to find the outcome of use of NAC in rodenticide poisoning.  The main objectives of this study were to determine the role of NAC in liver impairment rodenticide poisoning patients.   

Methods: A record based observational study was conducted for the period of 3 months from August 2019 to October 2019 at Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar, Tamil Nadu. Data were collected according to the proforma designed and results were analyzed using standard methods.

Results: Out of 50 patients, 21 (42%) were males and 29 (58%) were females. Age group between 21-30 years contributes the highest 20 (40%). Majority of type of rodenticide compound consumed by patients were paste 29 (58%) and less than four hours 34 (68%) patients were admitted. Patients with abnormal liver functions were tested, serum glutamic oxaloacetic transaminase/ aspartate aminotransferase -12 patients, 7 treated with NAC. serum glutamic pyruvic transaminase/ alanine aminotransferase - 9 patients, 2 treated with NAC. 37 (74%) were recovered out of 50 (100%), among them 28 (56%) treated with NAC.

Conclusions: In liver impairment rodenticide poisoning patients, early use of NAC shows a significant result and the rate of recovery is also high.


N-acetylcysteine, Rodenticide poisoning, Liver impairment, Outcome

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World Health Organization. International Programme on Chemical Safety: Poisoning Prevention and Management. Available at

Pesticides VV. Pillay Modern Medical Toxicology. 4th ed. Jaypee Brothers Medical Publishers; 2013:386-398.

Balasubramanian K, Sethuraman VK, Balamurugesan K, Viswanathan S. A retrospective study of clinical profile and outcome of patients with rodenticide poisoning in a tertiary care hospital. Int J Advances Med. 2019;6(2):296-301.

Khurana P, Dalal JS, Multani AS, Tejpal HR. The study of aluminium phosphide poisoning in a tertiary care hospital, Amritsar. J Ind Acad Forens Med. 2011;33(4):971-3.

Mathai A, Bhanu MS. Acute aluminium phosphide poisoning: Can we predict mortality. Indian J Anaesthes. 2010;54(4):302.

Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A. A Review on Various Uses of N-Acetyl Cysteine Cell J. 2017;19(1):11-17.

Suneetha DK, Inbanathan J, Kannoth S, Reshma PK, Shashank MS. Profile of Rat Killer Poisoning Cases in a Tertiary Care Hospital at Mysore. Int J Scientific Study. 2016;3(12):264-7.

Srinivasa K, Yadukul, Madyastha M. Study of profile of poisoning cases reported to district hospital, Chamarajanagar, Karnataka. India Int J Basic Clin Pharmacol. 2016;5(4):1215-9.

Saravanan S, Karthik B. Efficacy of Early N-Acetylcysteine in Rat Killer Paste Poisoning. Int J Scientific Study. 2019;6(10):73-5.

Shukkoor AA, George NE, Thangavelu S. N-acetylcysteine, a boon for yellow phosphorus-induced acute liver failure. A Case Report Asian J Pharm Clin Res. 2019;12(8):1-3.

Venugopal R, Narayanasamy K, Chezhian A, Senthil Kumar R, Jasmine JJ. Rat Killer Poisoning vs. Liver Damage: A View in South Indian Patients of Tertiary Care Center. J Gastroint Dig Syst. 2018;8(3):1-6.

Saoji AA, Lavekar AS, Salkar HR. A case on suicidal poisoning associated with ratol and a perspective on yellow phosphorus poisoning. Int J Recent Trends Sci Technol. 2014;10:223-5.

Kharkongor MA, Mishra AK, Ninan KF, Iyadurai R. Early Use of Intravenous N-acetylcysteine in Treatment of Acute Yellow Phosphorus Poisoning. Case Report. 2017;15(2):136-8.

Mishra AK, Devakiruba NS, Jasmine S. Clinical spectrum of yellow phosphorous poisoning in a tertiary care centre in South India: A case series. Trop Doct. 2016;47:245-9.