Organophosphate Poisoning Key Points

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Organophosphate Poisoning

1. Organophosphate Basics
Chemicals found in insecticides and pesticides
Inhibits acetylcholinesterase, causing excess acetylcholine
Disrupts nervous system function

2. Clinical Features
Presents with muscarinic, nicotinic, and CNS effects
Remember mnemonics: DUMBBELS and SLUDGE
Key symptoms: GI issues, respiratory distress, cardiovascular changes, muscle weakness

3. Sources of Exposure
Common sources include insecticides, fertilizers, surface sprays
Found in household items like pet shampoos and pest control
Can include nerve agents like sarin

4. Diagnosing
Based on exposure history and symptoms
Confirm with RBC acetylcholinesterase activity test
Monitor plasma cholinesterase and electrolytes

5. Emergency Management
Begin with decontamination: remove clothing, wash skin
Secure airway and provide respiratory support
Treat with atropine and pralidoxime (2-PAM)

6. Supportive Care
Maintain continuous cardiac monitoring
Perform frequent neurological assessments
Provide IV fluids and correct electrolytes

7. Complications
Watch for respiratory failure and cardiovascular collapse
Monitor for seizures and coma
Be alert for intermediate syndrome 24-96 hours post-exposure

8. "Aging" Phenomenon
Organophosphates irreversibly bind to acetylcholinesterase
Makes enzyme permanently inactive
Renders pralidoxime treatment ineffective

9. Patient Education
Teach safe handling and storage of pesticides
Emphasize proper protective equipment use
Stress importance of seeking immediate medical help if exposed

10. Prognosis and Follow-up
Outcome depends on exposure severity and treatment speed
Mild to moderate cases often recover fully
Severe cases may be fatal or cause long-term neurological effects