title: [Three cases of organophosphate poisoning treated with pralidoxime iodide and whole-bowel irrigation].
abstract: We encountered three cases of organophosphate poisoning treated with pralidoxime iodide (PAM) and whole-bowel irrigation without atropine sulfate. All patients recovered without persistence or recurrence of toxic symptoms and without any somatic after effects. In case 1, a 48-year-old woman ingested approximately 5 g of ethylthiometon in a suicide attempt. She was transferred to the hospital because of cardiopulmonary arrest. After resuscitation, she was transferred to our center. She was placed on a ventilator and received i.v. PAM and polyethylene glycol-electrolyte through a nasojejunal tube for whole-bowel irrigation. Six days later, serum ChE was improved. In case 2, a 51-year-old man ingested approximately 30 g of malathion in a suicide attempt and was transferred to our center because of dyspnea. He was treated with PAM and whole-bowel irrigation, but did not require a respirator. Serum ChE already showed improvement the following day. In case 3, a 31-year-old man ingested approximately 50 g of DEP in a suicide attempt and was transferred to our center because of unconsciousness. He was treated with a respirator, PAM and whole-bowel irrigation. Serum ChE improved within two days. These cases suggest the possibility that preferential whole-bowel irrigation without atropine sulfate prevents the persistence or recurrence of the toxic effects of organophosphate.
authors.affiliation: Department of Critical Care Medicine, Iwate Medical University.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Makoto
authors.initials: M
authors.lastname: Onodera
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Endo
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Endo
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujita
mesh_terms: D000328:Adult; D000931:Antidotes / Q000008:administration & dosage*; D002801:Cholinesterase Reactivators / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D007422:Intestines; D008294:Malathion / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning; D009943:Organophosphorus Compounds; D011220:Pralidoxime Compounds / Q000008:administration & dosage*; D011759:Pyrrolidines / Q000506:poisoning*; D013406:Suicide, Attempted; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D000931:Antidotes; D002801:Cholinesterase Reactivators; D007306:Insecticides; D009943:Organophosphorus Compounds; D011220:Pralidoxime Compounds; D011759:Pyrrolidines; C088207:ethylthiometon sulfoxide; C007268:1-(2-(dodecyloxy)ethyl)pyrrolidine hydrochloride; C028797:pralidoxime; D008294:Malathion