| Organophosphate poisoning | |
|---|---|
| Other names | Organophosphate toxicity, organophosphate overdose, organophosphate intoxication |
 | |
| Phosphoric acid | |
| Specialty | Emergency medicine |
| Symptoms | Increased saliva, diarrhea, small pupils, muscle tremors, confusion |
| Usual onset | Within 12 hours[1] |
| Causes | Organophosphates[2] |
| Diagnostic method | Based on symptoms and confirmed by butyrylcholinesterase[2] |
| Differential diagnosis | Carbamate poisoning[2] |
| Prevention | decreasing access[2] |
| Medication | Atropine, oximes, diazepam[2] |
| Frequency | Nearly 3 million per year[3] |
| Deaths | >200,000 per year[2] |
Organophosphate poisoning is poisoning due to organophosphates (OPs).[4] Organophosphates are used as insecticides, medications, and nerve agents.[4] Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.[2] While onset of symptoms is often within minutes to hours, some symptoms can take weeks to appear.[5][1] Symptoms can last for days to weeks.[2]
Organophosphate poisoning occurs most commonly as a suicide attempt in farming areas of the developing world and less commonly by accident.[2] Exposure can be from drinking, breathing in the vapors, or skin exposure.[4] The underlying mechanism involves the inhibition of acetylcholinesterase (AChE), leading to the buildup of acetylcholine (ACh) in the body.[2] Diagnosis is typically based on the symptoms and can be confirmed by measuring butyrylcholinesterase activity in the blood.[2] Carbamate poisoning can present similarly.[2]
Prevention efforts include banning very toxic types of organophosphates.[2] Among those who work with pesticides the use of protective clothing and showering before going home is also useful.[6] In those who have organophosphate poisoning the primary treatments are atropine, oximes such as pralidoxime, and diazepam.[2][4] General measures such as oxygen and intravenous fluids are also recommended.[2] Attempts to decontaminate the stomach, with activated charcoal or other means, have not been shown to be useful.[2] While there is a theoretical risk of health care workers taking care of a poisoned person becoming poisoned themselves, the degree of risk appears to be very small.[2]
OPs are one of the most common causes of poisoning worldwide.[2] There are nearly 3 million poisonings per year resulting in two hundred thousand deaths.[2][3] Around 15% of people who are poisoned die as a result.[2] Organophosphate poisoning has been reported at least since 1962.[7]
References
edit- ^ a b Stoller, James K.; Michota, Franklin A.; Mandell, Brian F. (2009). The Cleveland Clinic Foundation Intensive Review of Internal Medicine. Lippincott Williams & Wilkins. p. 108. ISBN 9780781790796. Archived from the original on 2017-09-10.
- ^ a b c d e f g h i j k l m n o p q r s t Eddleston, Michael; Buckley, Nick A; Eyer, Peter; Dawson, Andrew H (February 2008). "Management of acute organophosphorus pesticide poisoning". The Lancet. 371 (9612): 597–607. doi:10.1016/S0140-6736(07)61202-1. PMC 2493390. PMID 17706760.
- ^ a b Berg, Sheri; Bittner, Edward A. (2013). The MGH Review of Critical Care Medicine. Lippincott Williams & Wilkins. p. 298. ISBN 9781451173680. Archived from the original on 2017-09-10.
- ^ a b c d King, Andrew M.; Aaron, Cynthia K. (February 2015). "Organophosphate and Carbamate Poisoning". Emergency Medicine Clinics of North America. 33 (1): 133–151. doi:10.1016/j.emc.2014.09.010. PMID 25455666.
- ^ Peter JV, Sudarsan TI, Moran JL (2014). "Clinical features of organophosphate poisoning: A review of different classification systems and approaches". Indian J Crit Care Med. 18 (11): 735–45. doi:10.4103/0972-5229.144017. PMC 4238091. PMID 25425841.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Quandt, SA; Hernández-Valero, MA; Grzywacz, JG; Hovey, JD; Gonzales, M; Arcury, TA (June 2006). "Workplace, household, and personal predictors of pesticide exposure for farmworkers". Environmental Health Perspectives. 114 (6): 943–52. doi:10.1289/ehp.8529. PMC 1480506. PMID 16759999.
- ^ Neurological Practice: An Indian Perspective. Elsevier India. 2005. p. 479. ISBN 9788181475497. Archived from the original on 2017-09-10.