title: Organophosphate and carbamate poisoning.
abstract: Organophosphates (OPs) and carbamates have a wide variety of applications, most commonly as pesticides used to eradicate agricultural pests or control populations of disease-carrying vectors. Some OP and carbamates have therapeutic indications such as physostigmine. Certain organophosphorus compounds, known as nerve agents, have been employed in chemical warfare and terrorism incidents. Both classes inhibit acetylcholinesterase (AChE) enzymes, leading to excess acetylcholine accumulation at nerve terminals. In the setting of toxicity from either agent class, clinical syndromes result from excessive nicotinic and muscarinic neurostimulation. The toxic effects from OPs and carbamates differ with respect to reversibility, subacute, and chronic effects. Decontamination, meticulous supportive care, aggressive antimuscarinic therapy, seizure control, and administration of oximes are cornerstones of management.
authors.affiliation: Department of Emergency Medicine, Children's Hospital of Michigan Regional Poison Control Center, Detroit Medical Center, Wayne State University School of Medicine, 4707 Street Antoine, Suite 302, Detroit, MI 48201, USA. Electronic address: aking@dmc.org.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: King
authors.affiliation: Department of Emergency Medicine, Children's Hospital of Michigan Regional Poison Control Center, Detroit Medical Center, Wayne State University School of Medicine, 4707 Street Antoine, Suite 302, Detroit, MI 48201, USA.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Aaron
mesh_terms: D000931:Antidotes / Q000627:therapeutic use; D002219:Carbamates / Q000506:poisoning*; D019468:Disease Management; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D062025:Organophosphate Poisoning; D010091:Oximes / Q000627:therapeutic use; D011041:Poisoning / Q000628:therapy*
chemical_list: D000931:Antidotes; D002219:Carbamates; D018727:Muscarinic Antagonists; D010091:Oximes
keywords: Atropine; Carbamate; Chemical warfare; Insecticides; Nerve agents; Organophosphate; Oxime; Pesticides