Chlorate toxicity

Background

• Potassium chlorate, barium chlorate, and sodium chlorate found in fireworks, match heads, and weed killers

Mechanism of Toxicity

• Oxidizers and attackers of sulfhydryl groups
• Cause methemoglobin formation

Clinical Presentation

• Abdominal pain
• Vomiting
• Diarrhea
• Methemoglobinemia
• Coagulopathy

Evaluation

• Co-oximetry
• Additional evaluation based on clinical presentation and presence of methemoglobinemia
• No specific serum levels are available

Management

• Activated charcoal IS recommended
• Methylene blue for methemoglobinemia (1-2 mg/kg of 1% solution)
• Sodium thiosulfate IV may inactivate chlorate ions (anecdotal)
• Hemodialysis
• Supportive care

References

Olson, K. Poisoning and Drug Overdose, 1999.

Authors:

Ben Isakson, Claire, Michael Holtz, Ross Donaldson, Michael O'Brien, MD