Bentazon (bentazone) is a selective contact herbicide with the chemical structure shown in Figure 78-6.
Mechanisms of Toxicity
Its mechanism of action in humans is unknown, although the clinical features of poisoning suggest that bentazon may uncouple oxidative phosphorylation. It is likely that coformulants will be responsible for some of the toxic effects of some products.
Toxicokinetics
What little is known of the toxicokinetics of bentazon in humans indicates that it is rapidly and extensively absorbed after oral administration and excreted largely unchanged in urine. A possible hydroxylated metabolite was present in the blood of a farmer who died after ingestion of bentazon, the concentration of the parent compound in plasma being of the order of 1500 mg/L.215 In another case, the postmortem blood concentration of bentazon was 625 mg.216
Clinical Features
The three reported cases of acute poisoning in humans involve ingestion. Analytic confirmation of the presence of bentazon was present in two,215,216 but not in the third case.217 The emerging pattern of bentazon poisoning is that the time required for onset of features may be less than 1 hour and that death may result within as little as 2 hours. Upper and lower gastrointestinal irritation is common, and although bentazon is said not to cross the blood-brain barrier in rats, drowsiness, agitation, talking nonsense, and loss of consciousness in these patients suggest that it may do so after consumption of very large amounts. Other features include sweating, hyperpyrexia, increased heart rate, tachypnea, and difficulty in breathing. Limb rigidity was a prominent feature in two patients, and one had clear evidence of rhabdomyolysis and several other features; those who cared for him proposed that acute bentazon poisoning mimicked neuroleptic malignant syndrome.217 Leucocytosis and minor disturbances of liver and renal function have been reported.217
Management
The management of acute bentazon poisoning is symptomatic and supportive. Gastric lavage or oral activated charcoal (100 g for an adult) may be employed, although there are no data to indicate that they might be effective. Indeed, it is unlikely that they would be effective because absorption is so rapid. Liver and renal function and the ECG should be monitored. Dantrolene may be indicated if muscle rigidity is a problem.217 Respiratory and renal failure should be managed conventionally. Antiemetics may be given if vomiting persists.
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