Organophosphate Insecticide Poisoning and its Management

The organophosphate insecticides have become widely used in agriculture and in home gardening. There has been an increase in accidental and intentional poisoning. Almost all these compounds are potent cholinesterase inhibitors, and signs of poisoning are attributable to the accumulation of acetylcholine. The local absorption of these compounds from the conjunctiva, upper respiratory tract and skin following exposure to the aerosol or dust used in agricultural work, produces mild symptoms and is rarely of consequence except in accidents due to careless handling. The severe type of poisoning is caused usually by ingestion of the compound(s), and accumulation of large amounts of acetylcholine is fatal if not antagonized rapidly by atropine in large and continuous doses, together with respiratory support. Pyridine-2-Aldoxime Methiodide (P-2-AM) has been reported to be successful in treating Parathion poisoning. There is experimental evidence that it is not of similar value in some other organophosphorus insecticide poisoning.