management of organophosphate poisoning

1. ORGANOPHOSPHATE
POISONING
Dr pramod sarwa
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2. INTRODUCTION
• Organophosphate  widely used in agricultural
sector as PESTICIDES.
• Nerve agents  sarin, tabun, soman, VX, VE
• Mortality a/w self-poisoning with pesticides:
– 50-70 % in developing world
– 0.3 % in developed world , jrccth
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4. classification
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5. PHYSIOLOGY REVISITED
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8. MECHANISM OF ACTION OF
ORGANOPHOSPATE POISONING
Irreversibly bind to serine-OH group at the
active site of acetylcholinesterase (AChE) 
establish covalent bond (phosphorylation)
↓
AGING: loss of alkyl group + strengthening of
covalent bond
↓
Phosphorylated AChE is very stable
↓
Inhibition of enzyme activity  accumulation of
ACh in the synapse and NMJ
↓
Overstimulation of cholinergic receptors
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15. CLINICAL PRESENTATION
MUSCARINIC: SLUDGE
S-Salivation
L-Lacrimation
U-Urination
D-Diarrhoea
G-GI upset
E-Emesis
NICOTINIC: MATCH
M-Muscle weakness
and fasciculation
A-Adrenal medulla
activity ↑
T-Tachycardia
C-Cramping of skeletal
muscle
H-Hypertension
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