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ACUTE EXPOSURE INFORMATION

1. Fluoroacetamide is a fluoro ester compound used as a rodenticide, insecticide, miticide, and aphicide. Few specific data were available specifically about the toxicity of fluoroacetamide in humans; its toxicity is predicted to be similar to that of FLUOROACETATE, with convulsions, coma, nausea, and vomiting.
   1. In one experimental animal study, FLUOROACETAMIDE caused coma and death, but NOT convulsions. In two human poisoning cases, serious cardiac arrhythmias were noted; grand mal seizures occurred in one case.
      1. Fluoroacetamide may be absorbed and cause systemic poisoning after ingestion or dermal contact. It is unclear whether or not fluoroacetamide can be absorbed by the inhalation route.
   2. Fluoroacetamide is a colorless crystalline powder solid which is freely soluble in water. It is synthesized from fluoroacetyl chloride by a variety of processes. The use of fluoroacetamide is restricted to licensed pesticide applicators.
   3. The following review discusses the toxicity and treatment of poisoning with FLUOROACETATE.

2. Clinical effects are usually seen within 1/2 hour of exposure. Nausea, vomiting, excessive salivation, abdominal pain, numbness, a tingling sensation, and apprehension are seen initially, and may last for up to 6 hours. Muscular twitching, blurred vision, and hypotension may develop.
   1. Coma, convulsions, and cardiac arrhythmias may be delayed in onset for as long as 20 hours. One death due to subacute fluoroacetate poisoning has been reported.
   2. Cardiac effects may include tachycardia, ventricular fibrillation, and sudden onset of asystole.
   3. Death may occur from respiratory depression and hypoxia during convulsions or cardiac arrest.
   4. Neurologic sequelae and acute renal failure have been described after acute poisoning.
   5. Metabolic acidosis, hyperglycemia, hyperuricemia, elevated serum levels of hepatic transaminases, and elevated serum creatinine levels may occur.

3. Severe poisoning with numbness and tingling of the face, excessive salivation, blurred vision, peripheral paresthesias, convulsions, and coma followed inhalation and dermal contact with fluoroacetate. Fluoroacetate can be absorbed following ingestion and inhalation, but not through intact skin.

4. Fluoroacetate mimics acetic acid and reacts with coenzyme A and oxaloacetic acid, forming fluorocitric acid which enters and blocks the Kreb's cycle, allowing accumulation of citric acid.

5. Fluoroacetamide releases toxic and irritating fumes of fluoride and oxides of nitrogen when heated to decomposition. Inhalation of such combustion products would be predicted to result in respiratory tract irritation with bronchospasm, chemical pneumonitis, or noncardiogenic pulmonary edema.

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