What are the presentations of organophosphate poisoning?
The typical toxidrome in organophosphate (OP) poisoning comprises of the Salivation, Lacrimation, Urination, Defecation, Gastric cramps, Emesis (SLUDGE) symptoms.
Which drug is used in organophosphorus poisoning?
Medication Summary. The mainstays of medical therapy in organophosphate (OP) poisoning include atropine, pralidoxime (2-PAM), and benzodiazepines (eg, diazepam). Initial management must focus on adequate use of atropine.
How does organophosphate poisoning work?
Organophosphates and carbamates are absorbed through the gastrointestinal tract, lungs, and skin. They inhibit plasma and red blood cell (RBC) cholinesterase, preventing breakdown of acetylcholine, which then accumulates in synapses. Carbamates are cleared spontaneously within about 48 hours after exposure.
Why are organophosphates very important clinically?
Organophosphates (OPs) are used primarily as pesticides, but many (eg, Sarin and VX) are also used as chemical warfare agents. These compounds inhibit the activity of acetylcholinesterase resulting in the accumulation of acetylcholine at receptors on neurons in the central and peripheral nervous systems.
Why atropine is used in organophosphorus poisoning?
Atropine competitively blocks the effects of acetylcholine, including excess acetylcholine due to organophosphorus poisoning, at muscarinic cholinergic receptors on smooth muscle, cardiac muscle, secretory gland cells, and in peripheral autonomic ganglia and the central nervous system.
How is atropine given in OP poisoning?
The definitive treatment for organophosphate poisoning is atropine, which competes with acetylcholine at the muscarinic receptors. The initial dose for adults is 2 to 5 mg IV or 0.05 mg/kg IV for children until reaching the adult dose.
What is the mode of action of organophosphorus insecticides?
The primary mechanism of action of organophosphate pesticides is inhibition of carboxyl ester hydrolases, particularly acetylcholinesterase (AChE). AChE is an enzyme that degrades the neurotransmitter acetylcholine (ACh) into choline and acetic acid.
What is organophosphate used for?
Organophosphates are the most widely used insecticides today. They are used in agriculture, the home, gardens, and veterinary practice. Organophosphate insecticides (such as diazinon) are one type of pesticide that works by damaging an enzyme in the body called acetylcholinesterase.
What is muscarinic poisoning?
Muscarine poisoning is characterized by miosis, blurred vision, increased salivation, excessive sweating, lacrimation, bronchial secretions, bronchoconstriction, bradycardia, abdominal cramping, increased gastric acid secretion, diarrhea and polyuria.
How is muscarinic poisoning treated?
Severe muscarinic symptoms may be treated with the infusion of small doses of atropine. In muscarine poisoning, the entire episode usually subsides in 6-8 hours; some symptoms may take up 24 hours to fully resolve.
What type of inhibitor is organophosphorus?
Organophosphates are agricultural insecticides. These agents inhibit the enzyme acetylcholinesterase, which is responsible for the degradation of acetylcholine. The organophosphate binds to the enzyme, causing it to undergo a conformational change at its binding site to acetylcholine.
What you should know about organophosphate poisoning?
very narrowed pupils
What are the symptoms of organophosphate poisoning?
Signs and symptoms. Possible symptoms of organophosphate poisoning include narrowed pupils,and glazed over or watery eyes.
What are the symptoms of organic phosphate poisoning?
Litovitz TL,Bailey KM,Schmitz BF,Holm KC,Klein-Schwartz W.
Do you have organophosphate poisoning?
You must have a high clinical suspicion for organophosphate poisoning when no history of exposure or ingestion is known. Some organophosphates have a distinct garlic or petroleum odor that may help in diagnosis. If organophosphate poisoning is on the differential but not confirmed, a trial of atropine may be employed.