Organophosphate poisoning
| Organophosphate poisoning | |
|---|---|
| organophosphate toxicity, organophosphate overdose, organophosphate intoxication | |
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| Specialty | Emergency medicine |
| Symptoms | increased saliva, diarrhea, small pupils, muscle tremors, confusion |
| Usual onset | within 12 hours |
| Causes | organophosphates |
| Diagnostic method | based on symptoms and confirmed by butyrylcholinesterase |
| Differential diagnosis | carbamate poisoning |
| Prevention | decreasing access |
| Medication | atropine, oximes, diazepam |
| Frequency | nearly 3 million per year |
| Deaths | >200,000 per year |
| Classification | |
|---|---|
| External resources |
Organophosphate poisoning is poisoning due to organophosphates (OPs). Organophosphate are used as insecticides, medications, and nerve agents. Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion. While onset of symptoms is often within minutes to hours, some symptoms can take weeks to appear. Symptoms can last for days to weeks.
Organophosphate poisoning occurs most commonly as a suicide attempt in farming areas of the developing world and less commonly by accident. Exposure can be from drinking, breathing in the vapors, or skin exposure. The underlying mechanism involves the inhibition of acetylcholinesterase (AChE), leading to the build up of acetylcholine (ACh) in the body. Diagnosis is typically based on the symptoms and can be confirmed by measuring butyrylcholinesterase activity in the blood. Carbamate poisoning can present similarly.
Prevention includes banning very toxic types of organophosphates. In those who have organophosphate poisoning the primary treatments are atropine, oximes such as pralidoxime, and diazepam. General measures such as oxygen and intravenous fluids are also recommended. Attempts to decontaminate the stomach, with activated charcoal or other means, has not been shown to be useful. While there is a theoretical risk of health care workers taking care of a poisoned person becoming poisoned themselves, the degree of risk appears to be very small.
OPs are one of the most common causes of poisoning worldwide. There are nearly 3 million poisonings per year resulting in two hundred thousand deaths. Around 15% of people who are poisoned die as a result. Organophosphate poisoning has been reported at least since 1962.
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