title: Benefits of magnesium sulfate in the management of acute human poisoning by organophosphorus insecticides.
abstract: Organophosphorus chemicals (OPs) are the pesticides most often involved in serious human poisoning. Treatment of intoxication with OPs conventionally involves atropine for reduction of muscarinic signs and oximes that increase the rate of hydrolysis of the phosphorylated enzyme acetylcholinesterase (AChE). Although atropine and oximes (pralidoxime or obidoxime) are traditionally used in the management of such poisoning, their efficacy remains a major issue of debate; thus, the goal of this prospective clinical trial was to elaborate the value of magnesium sulfate (MgSO4) in the management and outcome of OP insecticide poisoning. This unicenter, randomized, single-blind trial study was conducted on patients who were acutely poisoned with OPs and admitted to the Poisoning Center of Loghman-Hakim Hospital in Tehran, Iran. In a systematic sampling, every fourth eligible patient was chosen to undergo MgSO4 treatment. Magnesium sulfate was administered at dose of 4 g/day i.v. continued for only the first 24 hours after admission. The mean daily oxime requirement and the mean daily atropine requirement were not statistically significant between two treated groups. The mortality rate and hospitalization days of patients who received MgSO4 treatment were significantly lower than those who had not received MgSO4 (P < 0.01). It is concluded that administration of MgSO4, in a dose of 4 g/day concurrent to conventional therapy, in OP acute human poisoning is beneficial by reducing the hospitalization days and rate of mortality.
authors.affiliation: Poison Control Center, Loghman-Hakim Hospital, School of Medicine, Shaheed-Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Abdolkarim
authors.initials: A
authors.lastname: Pajoumand
authors.forename: Shahin
authors.initials: S
authors.lastname: Shadnia
authors.forename: Ali
authors.initials: A
authors.lastname: Rezaie
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Abdi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abdollahi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001285:Atropine / Q000627:therapeutic use; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009768:Obidoxime Chloride / Q000627:therapeutic use; D062025:Organophosphate Poisoning; D010755:Organophosphates / Q000037:antagonists & inhibitors; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D016037:Single-Blind Method
chemical_list: D002801:Cholinesterase Reactivators; D007306:Insecticides; D018727:Muscarinic Antagonists; D010755:Organophosphates; D011220:Pralidoxime Compounds; D009768:Obidoxime Chloride; D008278:Magnesium Sulfate; D001285:Atropine; C028797:pralidoxime