# Toxic and Environmental Effects of Neonicotinoid Based Insecticides
## 2 Neonicotinoids and Its Effects after Human Exposure
They further reported that a 35-year-old male farmer ingested 350 mL of imidacloprid in a suicide attempt; thus, the patient displayed disorientation, drowsiness, dizziness, palpitations, and vomiting, which progressed to coma, tachycardia, hypertension, fever, leukocytosis, hypokalemia, etc. [17]. It is important to mention that the level of toxicity is very much dependent on the frequency and quantity or dose taken; hence, the safe field application of these chemicals may not cause such severe symptoms. _Clothianidin:_ Clothianidin is a neonicotinoid pesticide that is used against sucking and chewing insects [18]. As a broad-spectrum systemic insecticide, clothianidin is potent to a variety of pest species, including hemipterans, thysanopterans, orthopterans, coleopterans, lepidopterans, dipterans, hypnopterans, and isopterans [19]. It can be applied as a seed treatment or a soil or foliar spray [18]. Clothianidin products can have various agricultural or non-agricultural uses and can be formulated as granular, dust, or seed treatments; solid agars; pressurized liquids; emulsifiable or soluble concentrates; or ready-to-use solutions. Agriculturally, clothianidin can be used to protect vegetable and field crops, as well as tree fruits and nuts, from insect attacks. Clothianidin can be used non-agriculturally as well for turf and ornamental plants or for indoor and outdoor residential, commercial, and industrial sites [20]. _Acetamiprid:_ Acetamiprid has low toxicity in mammals; however, severe toxicity can result from ingesting large amounts [21]. As it is still a relatively new insecticide, acetaminophen poisoning is fairly uncommon. [PERSON] et al. reported that a 79-year-old man experienced consciousness disturbances, hypotension, nausea, vomiting, and hyperglycemia two hours after ingesting acetamiprid [22]. The next day, he was discharged from the hospital with improved symptoms [21,22]. [PERSON] et al. reported the case of a middle-aged farmer who experienced severe lactic acidosis, myocardial ischemia, refractory hypotension, and severe hypokalemia after ingesting 150 g of acetamiprid dissolved in water [21]. [PERSON] et al. reported the case of a 27-year-old man who presented vomiting, shortness of breath, and dizziness after the intake of 50 mL of acetamiprid [23]. The patient developed severe lactic acidosis, myocardial suppression, hyperglycemia, and intestinal obstruction [23]. _Thiacoprid_: Based on animal studies, the World Health Organization (WHO) classified thiacoprid as a class 2 pesticide that is moderately hazardous as it is likely a carcinogen [24]. [PERSON] et al. reported a fatal case of thiacoprid poisoning [24]. After the deliberate ingestion of 100 mL of thiacoprid suspension mixed with ethanol, a 23-year-old man experienced nausea, vomiting, tachycardia, hypertension, mydriasis with loss of light reflex, and respiratory paralysis. The patient eventually developed bradycardia, experienced cardiac arrest, and died 36 h after ingestion [24]. _Thiamethoxam_: First registered for use in the United States in 1999, thiamethoxam is an insecticide that is commonly used to control piercing and sucking insects, such as aphids, leafhoppers, and whitfely. Thiamethoxam is widely used for field, forage, fruit, spice, and vegetable crops, as well as for non-agricultural applications such as for residential dwellings, food handling establishments, and commercial, institutional, and industrial areas [20]. **Sulfoximine**: Other substitutes of neonicotinoids include sulfoximine. In a recent work, [PERSON] et al. [25] studied the acute oral toxicity of sulfoxaflor alone and in combination with a single dose of fluxapyroxad, a succinate dehydrogenase inhibitor (SDHI) fungicide, in three bee species: _Apis mellifera_, _Bombus terrestris_, and _Osmia bicornis_. They found that sulfoxaflor is somewhat less toxic than the recently banned neonicotinoids imidolorid, thiamethoxam, and clothianidin, but much more toxic than other neonicotinoids (acetamipid and thiacoprid). [PERSON] et al.