Agent orange
Background
- Member of chlorophenoxy pesticide group, and are often contaminated with dioxin
- Gained notoriety during Vietnam War
Mechanism
- Absorbed through skin, GI tract, and respiratory tract
- Acts on skeletal muscle but exact mechanism unknown
Clinical Features
- Serious toxic effects develop in 4-6 hours
- Non-specific dermal and GI irritation (nausea, vomiting, GI distress)
- Myotonia, muscle fasciculations, rhabdomyolysis, hyperthermia
Evaluation
- No specific tests for chlorophenoxy compounds
- Workup is aimed at detecting muscle injury and hepatic/renal function
Management
- Skin decontamination
- Supportive care
- Treat rhabdomyolysis, hyperthermia, and metabolic acidosis
