title: Pharmacokinetic Potentiation of Mixed Organophosphate and Pyrethroid Poison Leading to Prolonged Delayed Neuropathy.
abstract: Organophosphate (OP) and mixed pesticide poisoning remains an important cause of hospital admission. Therefore, physician must be aware of atypical presentations of delayed neurological complications of poisoning by taking proper patient history. We report a case of a 23-year-old female who presented with high stepping gait and muscle wasting in hands. Patient history revealed consumption of approximately 4ml of mixed pesticide, consisting of 50% chlorpyrifos with synthetic pyrethroid, 5% cypermethrin. The prolonged and severe nature of delayed peripheral neuropathy, persisting at two years of follow-up, suggests that even small quantities of OP taken in combination with a pyrethroid can result in significant morbidity and is irreversible.
authors.affiliation: Intern, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University , Manipal, Karnataka, India .
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Srinivasan
authors.affiliation: Postgraduate Student, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University , Manipal, Karnataka, India .
authors.forename: Ruhul
authors.initials: R
authors.lastname: Amin
authors.affiliation: Assistant Professor (Senior Scale), Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University , Manipal, Karnataka, India .
authors.forename: Girish
authors.initials: G
authors.lastname: Thunga
authors.affiliation: Professor, Department of Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Shivashankar Kaniyoor
authors.initials: SK
authors.lastname: Nagiri
authors.affiliation: Associate Professor, Department of Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Chandrashekar Udyavara
authors.initials: CU
authors.lastname: Kudru
keywords: Chlorpyrifos; Cypermethrin; Mixed poisoning