ORGANOPHOSPATE POISONING
Keywords:
Poisoning, organophosphorus compounds, acetylcholinesterase, antidote.Abstract
Organophosphorus poisoning is of great importance in the field of medicine due to its frequent use in agriculture, the poisoning by exposure to these agents can be occupational, accidental, and frequently due to voluntary intake. Organophosphorus’ intake most notable effects are produced by the inhibition of the acetyl cholinesterase, responsible for hydrolyzing acetyl choline.
Clinical manifestations of acute intoxication typically include bronchorrhea, salivation, lacrimation, bronchospasm, defecation, emesis, miosis, among others and they occur due to the stimulation of muscarinic and nicotinic receptors. Diagnosis is made through the interrogation and physical examination, in addition to the detection of acetyl cholinesterase levels or the organophosphates’ metabolites in blood testing. Management includes decontamination of the agent, review of respiratory status and access to ventilatory support, followed by pharmacological treatment that includes the use of atropine, pralidoxime and diazepam.
The present article constitutes a bibliographic review about the organophosphorus intoxication, its clinical manifestations, diagnosis and treatment.
References
2. Bird, S. Organophosphate and carbamate poisoning. Uptodate. [Internet]. [Consultado 1 diciembre 2018]. 2018;17–9. Disponible en: https://www-uptodatecom. ezproxy.sibdi.ucr.ac.cr/contents/organophosphate-and-carbamatepoisoning/print?search=intoxicaci%C3%B3n%20por%25%E2%80%A6.
3. Chowdhary S, Bhattacharyya R, Banerjee D. Acute organophosphorus poisoning. Clin Chim Acta [Internet]. [Consultado 1 diciembre 2018] 2014;431:66–76. Disponible en: http://dx.doi.org/10.1016/j.cca.2014.01.024
4. Slavica V, Dubravko B, Milan J. Acute organophosphate poisoning: 17 years of experience of the National Poison Control Center in Serbia. Toxicology. 2018;409(March):73–9.
5. King AM, Aaron CK. Organophosphate and Carbamate Poisoning. Emerg Med Clin North Am [Internet]. [Consultado 1 diciembre 2018] 2015;33(1):133–51. Disponible en: http://dx.doi.org/10.1016/j.emc.2014.09.010
6. Narang U, Narang P, Gupta O. Organophosphorus Poisoning: A Social Calamity. J Mahatma Gandhi Inst Med Sci [Internet]. [Consultado 1 diciembre 2018] 2015;20(1). Disponible en: www.jmgims.co.in
7. Arroyo H, Fernández C. Tóxicos ambientales y su efecto sobre el neurodesarrollo. Med (Buenos Aires). 2013;73(I):93–102.
8. Marrero, S., González, S., Guevara, H. y Eblen A. Venezuela_2017. Comunidad y salud [Internet]. [Consultado 15 febrero 2019] 2017;17(1):30–41. Disponible en: http://www.scielo.org.ve/pdf/cs/v15n1/art05.pdf
9. Iyer R, Iken B, Leon A. Developments in alternative treatments for organophosphate poisoning. Toxicol Lett [Internet]. [Consultado 1 diciembre 2018] 2015;233(2):200–6. Disponible en: http://dx.doi.org/10.1016/j.toxlet.2015.01.007
10. Vale A, Lotti M. Organophosphorus and carbamate insecticide poisoning [Internet]. [Consultado 1 diciembre 2018] 1st ed. Vol. 131, Handbook of Clinical Neurology. Elsevier B.V.; 2015. 149-168 p. Disponible en: http://dx.doi.org/10.1016/B978-0-444-62627-1.00010-X
11. Sánchez-Santed F, Colomina MT, Herrero Hernández E. Organophosphate pesticide exposure and neurodegeneration. Cortex. 2016;74:417–26.
12. Virú Loza M. Manejo actual de las intoxicaciones agudas por inhibidores de la
colinesterasa: conceptos erróneos y necesidad deguías peruanas actualizadas Current treatment of cholinesterase inhibitors poisoning : misconceptions and need for updated Peruvian guidelin. An Fac med. 2015;4:431–7.
13. Jokanović M. Neurotoxic effects of organophosphorus pesticides and possible association with neurodegenerative diseases in man: A review. Toxicology. 2018;410(March):125–31.
14. Liu HX, Liu CF, Yang WH. Clinical study of continuous micropump infusion of atropine and pralidoxime chloride for treatment of severe acute organophosphorus insecticide poisoning. J Chinese Med Assoc [Internet]. [Consultado 15 febrero 2019] 2015;78(12):709–13. Disponible en: http://dx.doi.org/10.1016/j.jcma.2015.08.006
15. Pedrozo ME, Ocampos S, Galeano R, Ojeda A, Cabello A, De Assis D. Casos de intoxicación aguda por plaguicidas en la colonia Puerto Pirapó, Itapúa, Paraguay, febrero de 2014. Biomédica [Internet]. [Consultado 16 febrero 2019] 2017;37(2):158–63. Disponinble en: http://www.redalyc.org/articulo.oa?id=84350981005
16. Naughton SX, Terry A V. Neurotoxicity in acute and repeated organophosphate exposure. Toxicology [Internet]. [Consultado 16 febrero 2019] 2018;408(April):101–12. Disponible en: https://doi.org/10.1016/j.tox.2018.08.011
17. Cortés Iza SC, Rodríguez AI, Prieto Suárez E. Assessment of hematological parameters in workers exposed to organophosphorus pesticides, carbamates and pyrethroids in Cundinamarca 2016-2017. Rev Salud Pública [Internet]. [Consultado 15 febrero 2019] 2017;19(4):2–6. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/viewFile/68092/65611%0Ahttps://revistas.unal.edu.co/index.php/revsaludpublica/article/view/68092
18. Deng J, Lu D, Zhang X, Shi G, Zhou T. Highly sensitive GQDs-MnO2 based assay with turn-on fluorescence for monitoring cerebrospinal acetylcholinesterase fluctuation: A biomarker for organophosphorus pesticides poisoning and management. Environ Pollut [Internet]. [Consultado 16 febrero 2019] 2017;224:436–44. Disponible en: http://dx.doi.org/10.1016/j.envpol.2017.02.024
19. Eddleston M, Chowdhury FR. Pharmacological treatment of organophosphorus insecticide poisoning: The old and the (possible) new. Br J Clin Pharmacol. 2016;81(3):462–70.
20. Peter J, Sudarsan T, Moran J. Clinical features of organophosphate poisoning: A review of different classification systems and approaches. Indian J Crit Care Med. 2014;18(11):805.
21. Rahim AA, Vandana KE, Varma M, Prabhu N, Nilima, Priyendu A, et al. Antibiotic prophylaxis in organophosphorus poisoning: A study of health and economic outcomes. Saudi Pharm J [Internet]. [Consultado 15 febrero 2019] 2016;25(3):332–6. Disponible en: http://dx.doi.org/10.1016/j.jsps.2016.07.006
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