Organophosphate poisoning

Describe the major clinical features of OP poisoning

*D*iarrhoea *U*rination *M*iosis/muscle weakness *B*ronchorrhea *B*radycardia *E*mesis *L*acrimation *S*alivation/sweating

What is mechanism of toxicity in OP poisoning?

It binds to acetylcholinesterase and inhibits the enzyme thus causing accumulation of acetylcholine causing hyperstimulation of the parasympathetic pathway

Why the routinely used methods to enhance elimination of poisons such as hemodialysis and hemoperfusion are ineffective to treat OP poisoning?

OP binds irreversibly to cholinesterase (aging process).

What is the specific treatment (antidote) for OP poisoning?

PAM and atropine ( because PAM can not cross CNS barrier while atropine can.)

Which methods of decontamination are useful in OP poisoning?

decontamination, clean patients with soap and water , irrigate the eyes of patients who have had ocular exposure using isotonic sodium chloride solution or lactited ringer's solution

How OP poisoning is diagnosed in the clinic?

decreases in plasma pseudocholinestrase in red blood cells & acute cholinesterase activity

What are the emergency and supportive measures to treat OP poisoning?

endotrachial intubation, IV and ventilation

What are the common sources of OP poisoning?

insecticide, pesticides in houses and farms