title: Management of exogenous intoxication by carbamates and organophosphates at an emergency unit.
abstract: OBJECTIVE
  to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates.
  
  
  METHODS
  a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE) between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects.
  
  
  RESULTS
  seventy patients (average age: 25 ± 19.97) formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total). Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p = 0.0006), nausea (p = 0. 0029) and emesis (p < 0.0001). The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p < 0.0001).
  
  
  CONCLUSIONS
  it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Sydney Correia
authors.initials: SC
authors.lastname: Leão
authors.affiliation: Health Sciences Post Graduate Program, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
authors.forename: José Fernandes de
authors.initials: JF
authors.lastname: Araújo
authors.affiliation: Health Sciences Post Graduate Program, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
authors.forename: Alessandro Rodrigues
authors.initials: AR
authors.lastname: Silveira
authors.affiliation: Group of Molecular Anatomy, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil.
authors.forename: Alex André Ferreira
authors.initials: AA
authors.lastname: Queiroz
authors.affiliation: Group of Molecular Anatomy, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil.
authors.forename: Maria Júlia Silveira
authors.initials: MJ
authors.lastname: Souto
authors.affiliation: Group of Molecular Anatomy, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil.
authors.forename: Rodrigo Oliveira
authors.initials: RO
authors.lastname: Almeida
authors.affiliation: Group of Molecular Anatomy, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil.
authors.forename: Diego Carvalho
authors.initials: DC
authors.lastname: Maciel
authors.affiliation: Parasitic Biology Post Graduate Program, Morphology Department, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil.
authors.forename: Tânia Maria de Andrade
authors.initials: TM
authors.lastname: Rodrigues
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001285:Atropine / Q000008:administration & dosage / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002219:Carbamates / Q000506:poisoning*; D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005260:Female; D005751:Gastric Lavage / Q000592:standards; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D002219:Carbamates; D018680:Cholinergic Antagonists; D002606:Charcoal; D001285:Atropine