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ACUTE EXPOSURE INFORMATION

  1. Ingestion of concentrated diquat solutions may result in severe systemic toxicity and death. Systemic toxicity has also been reported after contact with concentrated solutions. Local GI tract injury may occur due to the corrosive effects of concentrated solutions.
    1. No substantiated human case reports of systemic diquat poisoning or deaths have been reported following either dermal exposure (intact skin) or inhalation of diquat spray mist. Systemic toxicity may be possible after topical exposure to damaged skin. Systemic toxicity has been reported in a patient following the intravaginal application of diquat solution.
  1. With ingestion of approximately 1 gram of diquat or less, acute effects include an initial burning sensation of the oral and pharyngeal mucosa. Depending upon the amount ingested, nausea, repeated vomiting, and abdominal discomfort and pain may begin immediately, followed by extensive diarrhea. Renal impairment may develop, but recovery generally occurs after several days.
  1. Moderate to severe poisoning develops after ingestion of 1 to 12 grams; ingestion of 6 grams or more may be fatal. Toxicity can affect all organ systems and result in death within 24 to 48 hours.
    1. Larger doses can produce ulcerations of the digestive tract, pulmonary edema, acute liver and kidney failure, and rapid loss of consciousness.
    1. Ileus can occur during the first few days of poisoning, with accumulation of fluid and gas in the gut, abdominal distention, dehydration, and possible hypotension.
    1. Oliguria may occur within 10 to 12 hours of ingestion, with elevation of BUN and serum creatinine. During the first 3 to 4 days, a progressive decline in renal function may occur until the patient becomes anuric. This condition generally begins to reverse by days 7 to 10. Normal renal function returns about 2 to 3 weeks following ingestion. Hemodialysis may be required in the interim.
    1. Less common effects after ingestion include pneumonia, ventricular dysrhythmias, seizures, and non-cardiogenic pulmonary edema. Liver injury may develop but is generally mild and reversible. About two thirds of patients survive ingestion of up to 12 grams with good supportive care.
  1. Ingestion of more than 12 grams is nearly always fatal. The rapid onset of renal failure, ileus, ventricular dysrhythmias, coma or pulmonary complications requiring intubation/ventilation all suggest a poor prognosis. Death occurs from multi-organ system failure.
  1. Unlike paraquat, diquat has not caused pulmonary fibrosis in humans.
  1. CHRONIC TOXICITY - There are no substantiated reports of subchronic or chronic diquat toxicity in humans.
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