Case 11: Organophosphate Poisoning

What are some of the ways that organophosphates can get into circulation?

Across skin or mucous membranes, by inhalation, or by ingestion

How does atropine work to treat organophosphate poisoning?

Atropine works by antagonizing the muscaric receptor

What are the nicotinic symptoms of organophosphate poisoning?

Cardiac problems such as hypertension, tachycardia, arrhythmias, muscle problems such as fasciculations, tremors, and weakness, and respiratory failure

What does dumbbells stand for?

Diarrhea, Urination, Miosis, Bradycardia, Bronchorrhea, Emesis, Lacrimation, and salivation

What is the mnemonic to remember the symptoms of cholinergic toxicity?

Dumbbells.

What are the muscarinic symptoms of organophosphate poisoning?

Gastrointestinal symptoms such as nausea, vomiting, and fecal and urinary incontinence, cardiac symptoms such as hypotension, bradycardia, and tearing, drooling, and miosis

If you are working in an emergency room and a patient comes in with abdominal pain, cough, drooling, and tearing after playing in a field that was recently sprayed for insects, what is the most likely diagnosis?

Organophosphate poisoning

What is the leading caue of nonpharmaceutical ingestion fatality in children?

Organophosphate poisoning

What are organophosphates often a component of?

Pesticides

What should parents do to prevent their children from getting accidental poisonings?

Poison proof their house

How does pralidoxine work to treat organophosphate poisoning?

Pralidoxime is a cholinesterase reactivating oxime that can reactivate the acetylcholinesterase that has been deactivated

How is organophosphate poisoning confirmed?

Serum pseudocholinesterase and erythrocyte cholinesterase levels

What is the best therapy for a patient with organophosphate poisoning?

Supportive care, decontamination, and treatment with atropine and pralodoxime

Children younger than what age are at the greatest risk for accidental poisonings?

Under 5