Conditions · Metabolism (biochemistry)
Fluoroacetate poisoning !
Fluoroacetate is a highly toxic rodent poison; the body turns it into a compound that stops the Krebs cycle.
Updated 2026-10-31
Structures involved
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In biochemistry
What it is
Poisoning by sodium fluoroacetate (compound 1080) or fluoroacetamide, pesticides banned or restricted in many countries. There is no approved specific antidote.
Causes
- Accidental or deliberate ingestion of rodenticides
- Plants that contain it naturally (in Africa, Australia and South America)
Risk factors
- Illegal or poorly stored rodenticides
- Small children at home
Pathophysiology
Citrate synthase joins fluoroacetyl-CoA to oxaloacetate to make fluorocitrate ('lethal synthesis'), which blocks aconitase. The Krebs cycle stops, citrate builds up and binds calcium (hypocalcemia), ATP falls and lactate rises. Heart and brain, the most energy-hungry organs, fail first.
Symptoms and signs
- Onset after a delay of 30 minutes to several hours
- Nausea, vomiting, abdominal pain
- Agitation, seizures, coma
- Ventricular arrhythmias and low blood pressure
Diagnosis
- Clinical
- A history of rodenticide ingestion with neurological and cardiac symptoms after a delay.
- Tests
- Blood gases and lactate (metabolic acidosis), ionised calcium and potassium, continuous ECG; high blood citrate if available; toxicology testing of the product.
- Imaging
- There is no characteristic imaging; brain CT rules out other causes of seizures.
Treatment
- Acute
- Intensive care support: airway, seizure and arrhythmia control
- Medical
- Correction of calcium and potassium; activated charcoal if ingestion is recent
- Follow-up
- Prolonged cardiac monitoring because of the delayed onset
Complications
- Death from arrhythmia or respiratory failure
- Brain damage from prolonged seizures
Prevention
- Do not use illegal rodenticides; store them out of children's reach
Test yourself
Think of the answer, then tap the question to see it.
Which enzyme turns fluoroacetate into the real poison?
Citrate synthase, which makes fluorocitrate.
Which enzyme does fluorocitrate block?
Aconitase.
Why does hypocalcemia appear?
The accumulated citrate binds calcium.
Related conditions
Educational information, not medical advice. For any symptom, see a health professional.
Sources: Sodium Fluoroacetate (CID 16212360) (PubChem, NCBI, 2026) · Public domain; Citric acid cycle (TCA cycle) (Reactome, 2026); Textbook of Biochemistry for Medical Students, 6th ed. (Jaypee Brothers Medical Publishers (Vasudevan DM, Sreekumari S, Vaidyanathan K), 2011).
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