A dose >= 0.1 mg/kg are associated with significant mortality. The death rate is if very high with doses are > 0.8 mg/kg. Lower doses can be fatal if the patient has comorbid conditions that interfere with excretion (renal failure, extrahepatic biliary obstruction, etc).
Initial clinical findings during Stage 1 (10 to 24 hours after the exposure):
(1) pain in the mouth and throat
(2) severe nausea and vomiting
(3) diarrhea
(4) abdominal pain
(5) anorexia
(6) dehydration, hypovelemia and electrolyte imbalances
(8) leukocytosis in the peripheral blood
Clinical findings during Stage 2 (48 hours to 7 days after the exposure):
(1) bone marrow depression with anemia, thrombocytopenia and neutropenia
(2) secondary infection
(3) spontaneous hemorrhage secondary to thrombocytopenia or DIC
(4) altered mental status (confusion, delirium, coma)
(5) convulsions
(6) acute respiratory distress syndrome (ARDS)
(7) cardiac arrhythmias and/or cardiogenic shock
(8) hepatic dysfunction with or without hepatic failure
(9) acute renal failure
(10) rhabdomyolysis
(11) metabolic acidosis
(12) peripheral neuropathy with ascending paralysis
(13) electrolyte imbalances
Late clinical findings during the recovery phase:
(1) alopecia
(2) rebound leukocytosis
