title: [Clinical aspects, analysis and follow-up of poisoning with the alkyl phosphate demeton-S-methylsulfoxide (Metasystox R)].
abstract: We report on a 52-year old woman who had taken an unknown dose of the organophosphate insecticide Metasystox R with suicidal intention. Ingestion was followed by cardio-respiratory failure. After successful cardio-pulmonary resuscitation, main therapeutic principles were the immediate application of atropine and decontamination procedures such as gastric lavage, induction of diarrhoea and instillation of carbon. A single combined haemoperfusion and haemodialysis treatment was performed as a secondary elimination technique. After rapid toxicological analysis, obidoxime was administered as a supplementary antidote. After 14 days of treatment, the patient could leave the ICU with a complete restitution.
  
  
  CONCLUSIONS
  Our case report demonstrates the efficiency of immediate application of antidotal therapy (atropine), decontamination and elimination techniques even in case of cardio- respiratory failure after organophosphate poisoning. Toxicological analysis will be beneficial for diagnosis and the indication of further treatment with obidoxime.
authors.affiliation: Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg/Saar.
authors.forename: S
authors.initials: S
authors.lastname: Kleinschmidt
authors.forename: T
authors.initials: T
authors.lastname: Krämer
authors.forename: T
authors.initials: T
authors.lastname: Ziegenfuss
mesh_terms: D001285:Atropine / Q000008:administration & dosage; D003422:Critical Care / Q000379:methods; D062787:Drug Overdose / Q000097:blood / Q000628:therapy*; D005260:Female; D006323:Heart Arrest / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D007306:Insecticides; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D009946:Organothiophosphorus Compounds / Q000493:pharmacokinetics / Q000506:poisoning*; D013406:Suicide, Attempted
chemical_list: D007306:Insecticides; D009946:Organothiophosphorus Compounds; D001285:Atropine; C026086:methyl demeton
vernacular_title: Klinik, Analytik und Verlauf einer Intoxikation mit dem Alkylphosphat Demeton-S-Methylsulfoxid (Metasystox R).