Organophosphate Poisoning

Organophosphate Poisoning

What Are Organophosphates?

are an assorted group of chemicals used in both domestic and industrial settings.

WARNING!!

Most hospitals do NOT

actually carry enough Atropine

to treat one severe

organophosphate poisoned

Absorption

Primary examples:

LOOKS LIKE:

Can be through Oral, Dermal or Inhalation

OTHER USES:

• can be clear to brown in color, room temperature liquids
• usually supplied in aerosol or droplet form

If oral or dermal route, it is

absorbed through the small

intestine

• control of household and restaurant establishment pests, head lice in humans, and ectoparasites in domestic pests
• control of cereal and vegetable pests on commercial farms, and weed spray for lawns and garden

INSECTICIDES

NERVE GASES

HERBICIDES

VERMICIDES

OPTHALMIC AGENTS

Signs And Symptoms

Most practitioners will recognize the signs and symptoms of organophosphate poisoning by the acronym SLUDGE

If inhalation,

absorbed through the

lungs

Toxicity Amounts

AHS Management

Metabolism

• Salvation
• Lacrimation
• Urination
• Deification
• GI upset
• Emesis
• Miosis

The toxic dose for organophosphates is highly variable and toxicity can occur with minimal exposure. Toxicity will depend on variable such as the route in which it enters the body. Organophosphates can enter the body by absorption through the skin, inhalation, ingestion or ocular. It will also depend on variables such as the type, amount and concentration. Also previous exposures, age, weight, sex and current health status.

2mg Atropine IV/IO/IM

q5 til reversal of symptoms

Can happen from exposure up to 4 hours.

It is a slow release so you may see symptoms up to 48 hours to weeks later

Definitive Treatment

Response to Treatment

Pralidoxime Chloride (2-Pam) in hospital used in conjuction with Atropine.

In combat situations the military and medics are provided with a combo injector that holds both Atropine and Pralidoxime Chloride

Reversal of symptoms:

-Relieves spasms, paralysis, and

constriction of the respiratory muscles.

-decreases parasympathetic

stimulation

-dry up secretions

Pharmacokinetics

Absorption

Distribution

Metbolism

Elimination

WHY YOU TAKE IT

Signs And Symptoms

• exposure is usually accidental, however it has been known to contribute to suicidal, genocidal, military, and terrorist events
• recent studies however have shown a positive therapeutic use at extremely low doses for dementia and myasthenia gravis

Elimination

Distribution

Signs and Symptoms

Signs and Symptoms will depend on which ACH receptor is being affected. Muscarinic ACH receptors will be represented by the acronym DUMBELS and Nicotinic ACH recepors will be represented by the acronym MTWHF (days of the week wtih exception of Thursday)

This is an enzyme which is present in

serum bound to lipoproteints (HDL)

Is a diverse group of compounds with a wide range of lipid, water solubility, characteristics and variables.

Has a very large volume of

distribution.

Nicotinic ACH receptors MTWHF

Presented by

Signs and Symptoms

Alison, Liese, Tara, Trevor

Muscarinic Receptors

DUMBELS

• Mydriasis
• Tachycardia
• Weakness
• Hypertension
• Fasciculations

• Diarrhea
• Urination
• Miosis
• Abdominal Cramping
• Bradycardia
• Emesis
• Lacrimation
• Salvation, sweating