Organophosphate poisoning

What are organophosphates commonly used for?

Organophosphates have been used as insecticides.

What is the main action of organophosphates in the body?

They inhibit cholinesterase, leading to cholinergic toxicity.

What are the acute toxic effects of organophosphate poisoning?

Symptoms include SLUDGE (Salivation, Lacrimation, Urination, Defecation, Gastric Emptying), bradycardia, bronchorrhea, muscle weakness, and paralysis.

What is SLUDGE in the context of organophosphate poisoning?

SLUDGE stands for Salivation, Lacrimation, Urination, Defecation, Gastric Emptying.

What characterizes intermediate syndrome in organophosphate poisoning?

Occurs 24-96 hours after exposure with weakness, decreased reflexes, and respiratory insufficiency.

What is Organophosphate-Induced Delayed Neuropathy (OPIDN)?

A condition that occurs 1-3 weeks after exposure, leading to distal muscle weakness and sensory disturbances.

What investigations should be done for suspected organophosphate poisoning?

Check blood sugar, RBC acetylcholinesterase activity, FBC, renal and liver profile, and ECG.

What is the initial management for organophosphate poisoning?

Initiate atropine therapy and provide supportive care.

How does atropine work in cases of organophosphate poisoning?

Atropine competes with acetylcholine at muscarinic receptors to alleviate symptoms.

What is the recommended starting dosage for atropine in organophosphate poisoning?

Beginning at a dose of 2 to 5 mg IV for adults.

What is Pralidoxime (PAM) used for in organophosphate poisoning?

PAM is a cholinesterase reactivating agent effective in treating both muscarinic and nicotinic symptoms.

What adverse effects may occur during atropine therapy?

Confusion, absent bowel sounds, heart rate between 80-100 bpm, pyrexia, among others.

What supportive care is necessary in severe organophosphate toxicity?

Management of seizures, respiratory distress, fluid resuscitation, and potential intubation.

What is the significance of ECG monitoring in organophosphate poisoning management?

ECG monitoring is essential to detect QT prolongation, ST-T changes, and ventricular tachycardia.

When should gastric lavage be performed in suspected organophosphate poisoning?

If ingestion occurred within 1-2 hours of presentation.