Prompt recovery from severe cholinesterase-inhibitor poisoning--remarks on classification and therapy of organophosphate poisoning.
In organophosphate intoxication the assessment of both the degree of severity of poisoning and the initial dose of pralidoxime and atropine are as yet based only on clinical symptoms. We present three patients with clinically severe organophosphate poisoning in whom a prompt recovery from central nervous symptoms occurred after the administration of low doses of atropine and pralidoxime. It is suggested that the true severity of organophosphate intoxication as well as the initial therapy should be determined by the amount ingested, the propensity for aging, and the pharmacodynamic properties of the organophosphorus compound, as well as by the time interval between exposure and initiation of appropriate treatment, as far as these data can be verified in the individual patient.
De Wilde
V
V
Intensive Care Department, University Hospital of Ghent, Belgium.
Vogelaers
D
D
Colardyn
F
F
D000110:Acetylcholinesterase / Q000097:blood; D000328:Adult; D000368:Aged; D001285:Atropine / Q000008:administration & dosage*; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D002801:Cholinesterase Reactivators; D003131:Combined Modality Therapy; D062787:Drug Overdose / Q000145:classification / Q000628:therapy*; D004912:Erythrocytes / Q000201:enzymology; D005260:Female; D005284:Fenthion / Q000506:poisoning; D005751:Gastric Lavage; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010278:Parathion / Q000506:poisoning; D011220:Pralidoxime Compounds / Q000008:administration & dosage*
D002800:Cholinesterase Inhibitors; D002801:Cholinesterase Reactivators; D007306:Insecticides; D011220:Pralidoxime Compounds; D010278:Parathion; D001285:Atropine; D005284:Fenthion; D000110:Acetylcholinesterase; C028797:pralidoxime