![]() Of these cholinergic incidents, 120 (59%) patients required admission to a high-care or intensive care unit (ICU) 5 of them died. A review of cases (2003 - 2008) seen at Red Cross War Memorial Children's Hospital, Cape Town, SA, showed that of 311 pesticide incidents, 203 were caused by cholinergic pesticides (organophosphates and carbamates), leading to a median hospital stay of 3 days for symptomatic patients (n=195/203). In SA, data on organophosphate pesticide poisoning (OPP) in children are scarce. ![]() Unfortunately, many products are sold illegally for use as domestic rodenticides, where young children may be at risk of accidental exposure. Organophosphates are registered for use as pesticides in the agricultural sector in South Africa (SA). He required prolonged ventilatory support in the intensive care unit at his referral hospital and had subsequent delayed neurological recovery, spending 8 days in hospital.We present this case to emphasise the importance of adequate atropinisation in the management of severe OPP and to highlight the dangers of inappropriate use of suxamethonium for intubation in patients with OPP. IIIMB ChB, DCH (SA) Poisons Information Centre, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South AfricaĪ 17-month-old boy presented to a local community health centre in Cape Town, South Africa, with severe organophosphate pesticide poisoning (OPP), necessitating the use of intravenous atropine to control cholinergic symptoms, as well as emergency intubation for ongoing respiratory distress. IIMB BCh, FCPaed (SA) Paediatric Intensive Care Unit, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa IMB ChB, MSc (Paed) Poisons Information Centre, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa of Emergency Medicine (응급의학교실) > 1.Prolonged paralysis in a child with organophosphate pesticide poisoning However, it may be beneficial to administer pralidoxime for a sufficient period in case of severe poisoning with a large quantity of OP, which is common in Korea. ![]() There has been a great deal of controversy over the effectiveness of pralidoxime in acute OP poisoning. After some period of time, the acetylcholinesterase-OP compound undergoes a conformational change, known as aging, which renders the enzyme irreversibly resistant to reactivation by a pralidoxime. It is effective in treating both muscarinic and nicotinic symptoms. Pralidoxime is a biochemical antidote that reactivates acetylcholinesterase by removing OP from it. A large dose may be necessary to overcome the excessive cholinergic state in case of severe poisoning. ![]() ![]() Atropine should be immediately administered, and the dose can be titrated according to the severity of OP poisoning. Atropine works as a physiologic antidote by competitively occupying muscarinic receptor sites, reducing the effects of excessive acetylcholine. All symptomatic patients should receive therapy with oxygen, atropine, and pralidoxime. The dominant clinical features of acute cholinergic toxicity include bradycardia, miosis, lacrimation, salivation, bronchorrhea, and bronchospasm. Other Titles Antidote for organophosphate insecticide poisoning: atropine and pralidoxime Authors 정성필 노형근 Citation JOURNAL OF THE KOREAN MEDICAL ASSOCIATION, Vol.56(12) : 1057-1066, 2013 Journal Title JOURNAL OF THE KOREAN MEDICAL ASSOCIATION(대한의사협회지) ISSN 1975-8456 Issue Date 2013 Keywords Organophosphate Poisoning Antidote Atropine Pralidoxime Abstract Acute organophosphate (OP) poisoning produces cholinergic symptoms resulting from the inhibition of cholinesterase, and the overstimulation of muscarinic and nicotinic receptors in the synapses. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |