Toxicology of Acetylcholinesterase Inhibitors (III) - Management of Poisonings

This is the final part of the 3-part video series on the Toxicology of Acetylcholinesterase Inhibitors. The earlier 2 parts dealt with cholinergic neurotransmission and some examples of drugs and poisons respectively.

poisonings with acetylcholinesterase inhibitors happen from time to time, either as partof agricutural accidents or a terrorist attack.

In this video, the Cholinergic Toxidrome is reviewed. Additionally, there are CNS effects.

The main causes of mortality relate to a] excessive bronchial secretions (muscarinic effects), b] central respiratory depression c] respiratory muscle paralysis (nicotinic effects).

Management strategies include:
dry the airway (use of atropine, a muscarinic antidote)
support respiration (use of pralidoxime to regenerate the acetylcholinesterase enzyme)
respiratory support
prevention of seizure (use diazepam)

2 late syndromes are considered:
the Intermediate syndrome occuring days to weeks after severe exposure.
the organophosphate induced delayed neuropathy (OPIDN) occuring weeks after severe exposure

Learning Objectives of the 3 part videos -
Cholinergic neurotransmission
– role of acetylcholinesterase
Mechanism of action of acetylcholinesterase inhibitors
Cholinergic toxidrome
Some therapeutic agents, insecticides, nerve agents
Main causes of mortality in organophosphorous poisonings
Simple approach to therapeutics of such poisonings
Role of pralidoxime
Late poisoning syndromes

The first part of the series on 'Cholinergic neurotransmission' can be viewed here:
   • Toxicology of Acetylcholinesterase In...  

The second part covering 'Drugs and Poisons' can be found here:
   • Toxicology of Acetylcholinesterase In...  

The playlist of all 3 videos can be accessed here:
   • Acetylcholinesterase Inhibitors  

An enactment of the Cholinergic Toxidrome can be viewed here. This is excerpted from the TV series Homeland.
   • Cholinergic Toxidrome  

For of of these, please visit :
www.pharmacologytutorials.com

Edmund Lee