Advances in the management of organophosphate poisoning.
Organophosphate (OP) poisoning is commonly encountered in agricultural communities. The mainstay of therapy in OP poisoning is the use of atropine. However, several other therapies have been evaluated. Although oxime has been the most studied antidote, results in humans have been disappointing and limited by the lack of well-designed, prospective, randomised controlled trials. The key factor in determining outcomes in OP poisoning appears to be the timing of antidote administration. Other adjuvants, such as magnesium, fresh frozen plasma and haemoperfusion appear promising, and need to be explored further. A multi-faceted approach may be the answer to improving outcomes in OP poisoning. This review evaluates the advances in OP management over the last 20 years.
Peter
John Victor
JV
Christian Medical College & Hospital, Department of Medical Intensive Care, Vellore, India. peterjohnvictor@yahoo.com.au
Moran
John L
JL
Graham
Petra L
PL
D000931:Antidotes / Q000009:adverse effects / Q000627:therapeutic use*; D001285:Atropine / Q000627:therapeutic use; D016913:Blood Component Transfusion; D002619:Chemical Warfare Agents / Q000506:poisoning*; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D006464:Hemoperfusion; D006801:Humans; D019570:Inhalation Exposure; D017616:Magnesium Compounds / Q000627:therapeutic use; D062025:Organophosphate Poisoning; D010091:Oximes / Q000627:therapeutic use; D010575:Pesticides / Q000506:poisoning*; D010949:Plasma; D011041:Poisoning / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D013405:Suicide
D000931:Antidotes; D002619:Chemical Warfare Agents; D002801:Cholinesterase Reactivators; D017616:Magnesium Compounds; D010091:Oximes; D010575:Pesticides; D001285:Atropine; D017693:Sodium Bicarbonate