title: [Different therapeutic efficacy of pralidoxime chloride PAM-Cl on AChE against acute toxicity of methamidophos, dichlorvos and omethoate].
abstract: OBJECTIVE
  To observe the treatments on the patients with acute methamidophos dichlorvos (DDV) and omethoate poisoning and provide the reliable basis for the rational treatments on these three organophosphorus pesticides poisoning.
  
  
  METHODS
  101 patients with AOPP in 7 hospitals were divided into three groups: Group A, 59 patients with acute methamidophos poisoning, Group B, 32 patients with acute DDV/dipterex (DEP) poisoning, Group C, 10 patients with acute omethoate/dimethoate poisoning. The levels of erythrocyte AChE and the therapeutic efficacies of pralidoxime chloride (PAM-Cl) were compared among the three groups.
  
  
  RESULTS
  The AChE activities of all the three groups were inhibited on level of (9.12 +/- 7.99) U/g Hb (group A), 7.32 +/- 4.62 U/g Hb (group B) and (12.01 +/- 9.53) U/g Hb (group C), among which no significant difference was found (P > 0.05). All the patients recovered from acute cholinergic excitation or crisis after the treatment of PAM-Cl. The erythrocyte AChE activities were obviously reactivated in group A three hours later after admission to hospital, each on level of (11.37 +/- 8.67) U/g Hb, (12.51 +/- 6.98) U/g Hb, (15.90 +/- 7.31) U/g Hb, (18.33 +/- 4.78) U/g Hb and (18.91 +/- 7.00) U/g Hb at the 12th, 24th, 48th, 72nd hour and discharge (P < 0.05), and the upgrade tendency was continuous. AChE activities in group B were also reactivated after treatment, each on level of (8.91 +/- 5.89) U/g Hb, (1.31 +/- 6.61) U/g Hb, (13.00 +/- 7.55) U/g Hb, (14.22 +/- 7.80) U/g Hb, (12.78 +/- 7.07) U/g Hb and (16.87 +/- 7.06) U/g Hb at the 3rd, 12th, 24th, 48th, 72nd hour and discharge, but the upgrade tendency turned slowly after 12 hours, the inhibited AChE activities were not reactivated in group C from the beginning to the end.
  
  
  CONCLUSIONS
  After the treatment of PAM-Cl, the AChE activities of the patients with acute methamidophos poisoning could be continuously reactivated, the AChE activities of the patients with acute DDV/DEP poisoning could also be reactivated in 12 hours, and then keep stable, but the AChE activities of the patients with acute omethoate/dimethoate poisoning could not be reactivated. However, PAM-Cl has therapeutic efficacy against acute toxicity of all the three organophosphorus pesticides. Oximes should be vigorously used in the treatment of AOPP, including acute omethoate/dimethoate poisoning.
authors: Department of Occupational Disease, Huashan Hospital, Fudan University, Shanghai 200040, China. wgwan1969@sina.com
authors: Wei-Guo
authors: WG
authors: Wan
authors: Shu-cong
authors: SC
authors: Zheng
authors: He-jian
authors: HJ
authors: Zou
authors: Sheng-di
authors: SD
authors: Ma
authors: Guang-zhou
authors: GZ
authors: Tao
authors: Zu-fang
authors: ZF
authors: Xu
authors: Bin
authors: B
authors: Zhang
authors: Jia-jing
authors: JJ
authors: Chen
authors: Ling-yun
authors: LY
authors: Fang
authors: Zhi-jie
authors: ZJ
authors: Zhu
mesh_terms: D000110:Acetylcholinesterase / Q000378:metabolism*; D000208:Acute Disease; D000328:Adult; D002801:Cholinesterase Reactivators / Q000627:therapeutic use*; D004006:Dichlorvos / Q000506:poisoning; D004117:Dimethoate / Q000031:analogs & derivatives / Q000506:poisoning; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning; D009946:Organothiophosphorus Compounds / Q000506:poisoning; D011220:Pralidoxime Compounds / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D002801:Cholinesterase Reactivators; D009946:Organothiophosphorus Compounds; D011220:Pralidoxime Compounds; C002302:dimethoxon; D004006:Dichlorvos; C014655:methamidophos; D000110:Acetylcholinesterase; C028797:pralidoxime; D004117:Dimethoate