Cabrera OA, Varela RW

Language: Spanish
References: 18
Page: 161-167
PDF size: 486.91 Kb.

ABSTRACT

The use of organophosphorus pesticides results in toxicity risk. Organophosphorus compounds share a common mode of action, exerting their toxic effects primarily via acetylcholinesterase inhibition. Acute cholinergic crisis includes signs and symptoms resulting from hyperstimulation of central and peripheral muscarínico and nicotinic receptors. The current view of the treatment of the organophosphate poisoning includes three strategies, i.e. the use of atropine, oxime and benzodiacepines. The status of oximes in human organophosphate poisoning is controversial. Large randomised controlled trial is required to compare the current World Health Organisation-recommended pralidoxime regimen (›30mg/kg bolus followed by › 8 mg/kg/hr infusion) with placebo to determine definitively the role of oxime therapy in organophosphorus poisoning.

REFERENCES

1. Barthol CL, Schier JG. Organic phosphorus compound- nerve agents. Crit Care Clin 2005; 21 (4): 673-89

2. De Bleecker J. The Intermediate syndrome in organophosphate poisoning: An Overview of experimental and clinical observations. J Toxicol Clin Toxicol 1995; 33 (6): 683-686

3. De Silva HJ, Wijewickrema R, Senanayake N: Does pralidoxime affect outcome of management in acute organophosphorus poisoning? Lancet 1992; 339: 1136-1138

4. Eddleston et al. Differences betwen organophosphorus insecticides in human self-poisoning a prospective cohort study. Lancet 2005; 366: 1452-59.

5. Eddleston M, Buckley N, et al: Speed of initial atropinisation in significant organophosphorus pesticide poisoning- a systematic comparison of recommended regimens. J Toxicol Clin Toxicol, 2004; 42 (6): 865-875

6. Eddleston M, Buckley N, Eyer P, Dawson A. Management of acute organophosphorus pesticide poisoning. Lancet 2008; vol 371: 597-607.

7. Eddleston M, Dawson A, Karalliedde L, et al: Early management after self-poisoning with an organophosphate or carbamate pesticide- a treatment protocol for junior doctors. Crit Care 2004, R391-R397.

8. Eddleston M, Szinics L, Eyer P. Oximes in acute organophosphorus pesticide poisoning: a systematic review of clinical trials. Q J Med 2002, 95: 275-283

9. Geller RJ, Singleton KL, Tarantino ML, Drensek CL, Toomey KE: Nosocomial poisoning associated with emergency department treatment of organophosphate Toxicity- Georgia 2000. Clin Toxicol 2001: 39 (1): 109-111

10. Jimenez Murillo L, Montero Pérez FJ. Intoxicación por insecticidas organofosforados, carbamatos y organoclorados. En: Medicina de Urgencias y Emergencias: Guías diagnósticas y protocolos de actuación. 3ed, Elsevier, 2004, pp 666-673

11. Karalliedde L. Organophosphorus poisoning and anaesthesia. Anaesthesia 1999; 54: 1073-1088

12. Leikin JB, Thomas RG, Walter FG, Klein R, Meislin HW. A review of nerve agent exposure for the critical care physician. Crit Care Med 2002; 30(10):2346-54

13. Peter JV, Moran JL, Graham P. Oxime therapy and outcomes in human organophosphate poisoning: An evaluation using meta-analytic techniques. Crit Care Med 2006; 34 (2): 502-10

14. Roberts D M, Aaron C K: Managing acute organophosphorus pesticide poisoning. BMJ 2007; 334: 629-634.

15. Senanayake N, Karalliedde L. Neurotoxic effects of organophosphate insecticides: an intermediate syndrome. N Engl J Med 1987; 316: 761-763

16. Simpson W, Schuman S: Recognition and management of acute pesticide poisoning. Am Famil Physician 2002; 65:1599-1604

17. 17.Stacey R, Morfey D, Payne S. Secondary contamination in organophosphate poisoning: analysis de an incident. Q J Med 2004; 97: 75-80

18. Sungur M, Güven M: Intensive care management of organophosphate poisoning. Crit Care 2001, 5: 211-215.