[Different therapeutic efficacy of pralidoxime chloride PAM-Cl on AChE against acute toxicity of methamidophos, dichlorvos and omethoate].
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.
Wan
Wei-Guo
WG
Department of Occupational Disease, Huashan Hospital, Fudan University, Shanghai 200040, China. wgwan1969@sina.com
Zheng
Shu-cong
SC
Zou
He-jian
HJ
Ma
Sheng-di
SD
Tao
Guang-zhou
GZ
Xu
Zu-fang
ZF
Zhang
Bin
B
Chen
Jia-jing
JJ
Fang
Ling-yun
LY
Zhu
Zhi-jie
ZJ
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
D002801:Cholinesterase Reactivators; D009946:Organothiophosphorus Compounds; D011220:Pralidoxime Compounds; C002302:dimethoxon; D004006:Dichlorvos; C014655:methamidophos; D000110:Acetylcholinesterase; C028797:pralidoxime; D004117:Dimethoate