Role of Oximes in Human Organophosphate Poisoning—A Critical Look at the Evidence

Objective: To describe the role of plasmapheresis in management of organophosphate poisonings. Design: Case report. Setting: A medical intensive care unit of a medical faculty. Patient: A patient with organophosphate poisoning whose cholinesterase levels continuously decline and then increase up to a normal level after plasmapheresis is performed for his sepsis. Interventions: Plasmapheresis with fresh frozen plasma. Measurements and main results: Baseline plasma cholinesterase (ChE) level was 4001 IU/L (normal values: 4000-10000 IU/L). Aspiration pneumonia was developed on day 3, and sepsis occurred on day 5. During this period, ChE levels gradually decreased. On day 5, plasmapheresis was performed for sepsis. Interestingly, plasma ChE levels increased from 2101 IU/L to 6144 IU/L after plasmapheresis. Atropine and pralidoxime were stopped, and a high level of ChE continued during hospitalization. The patient was successfully weaned from mechanical ventilation 3 days after plasmapheresis. Conclusion: Plasma exchange therapy may be considered for patients with organophosphate poisoning unresponsive to atropine and pralidoxime.

Download Full-text

Delayed onset neuropathy along with recurrent laryngeal nerve palsy due to organophosphate poisoning and the role of physiotherapy rehabilitation

Indian Journal of Critical Care Medicine ◽

10.4103/0972-5229.126082 ◽

2014 ◽

Vol 18 (2) ◽

pp. 102-104 ◽

Cited By ~ 1

Author(s):

Niteen D. Karnik ◽

Jaimala Vijay Shetye ◽

Swati M. Surkar ◽

Amita A. Mehta

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Laryngeal Nerve ◽

Organophosphate Poisoning ◽

Delayed Onset ◽

Laryngeal Nerve Palsy

Download Full-text

Role of aliesterase in organophosphate poisoning*1

Fundamental and Applied Toxicology ◽

10.1016/0272-0590(84)90141-6 ◽

1984 ◽

Vol 4 (2) ◽

pp. S96-S105 ◽

Cited By ~ 82

Author(s):

J CLEMENT

Keyword(s):

Organophosphate Poisoning

Download Full-text

ORGANOPHOSPHATE POISONING

International Journal of Advanced Research ◽

10.21474/ijar01/12284 ◽

2021 ◽

Vol 9 (01) ◽

pp. 122-126

Author(s):

Ravi Jindal ◽

◽

Harinder Pal Singh ◽

Jaspreet Singh ◽

Navjot Kaur ◽

...

Keyword(s):

Organophosphorus Compounds ◽

Fresh Frozen Plasma ◽

Final Outcome ◽

Organophosphate Poisoning ◽

Early Management ◽

Fresh Frozen ◽

Frozen Plasma

Organophosphorus compounds are very commonly available substance especially in agriculture based countries. Its use as a suicidal agent is rampant. Early management of the patient is critical in the final outcome. Use of atropine forms the mainstay of management after early decontamination. The role of oximes has been a matter of controversy. Use of Fresh Frozen Plasma and monitoring the patient using cholinesterase levels is amongst one of the developments in the management of the patient.

Download Full-text

The role of serum cholinesterase activity and S100B protein in the evaluation of organophosphate poisoning

Human & Experimental Toxicology ◽

10.1177/0960327112474850 ◽

2013 ◽

Vol 32 (10) ◽

pp. 1081-1088 ◽

Cited By ~ 4

Author(s):

T. Yardan ◽

A. Baydin ◽

E. Acar ◽

F. Ulger ◽

D. Aygun ◽

...

Keyword(s):

Cholinesterase Activity ◽

S100b Protein ◽

Serum Cholinesterase ◽

Organophosphate Poisoning ◽

Serum Cholinesterase Activity

Download Full-text

Necrosis of Tongue: A Sequela of Complications in Organophosphate Poisoning

10.31487/j.jscr.2020.04.02 ◽

2020 ◽

pp. 1-3

Author(s):

Irfan Mohammed ◽

Sajid A. Sanadi

Keyword(s):

Early Identification ◽

Suicide Attempts ◽

Acute Poisoning ◽

Organophosphate Poisoning ◽

Intravenous Fluids ◽

Successful Management ◽

Medline Search ◽

Life Threatening ◽

Widespread Availability

Organophosphate compounds are mainly used in the agriculture and domestic pesticides. The widespread availability of these pesticides results in the inadvertent usage leading to the main agent used in suicide attempts in the developing countries. The severity of the poisoning greatly depends on the type of exposure, quantity and the product. They can cause life threatening complications mainly by the respiratory depression leading to coma and death. Early identification and appropriate management enable to reduce the morbidity and mortality. Atropine, oximes, intravenous fluids are administered for the successful management. A detailed medline search of the associated complications, although rare, necrosis of tongue is reported in only one case associated with organophosphate poisoning. The etiological factors were not mentioned in the found literature. In this case report, we discuss the sequela of complications associated with the acute poisoning cases and the role of maxillofacial surgeons in the management.

Download Full-text