Organophosphate Poisoning
Basics
Description
Description
- Organophosphates (pesticides and nerve agents) irreversibly bind and deactivate cholinesterases, including acetylcholinesterase
- Acetylcholine accumulates at neural synapses, causing central and peripheral cholinergic overdrive
- Predominant effects (muscarinic, nicotinic, CNS) may vary and can overlap
- Mortality is secondary to respiratory failure:
- Weakness of respiratory muscles
- Bronchorrhea and bronchoconstriction
- Central depression of respiratory drive
Pediatric Considerations
- Symptoms are difficult to differentiate in toddlers
- Common symptoms: Miosis, salivation, and muscle weakness
- Seizure activity in 25% of pediatric cases:
- Only 3% in adults
Etiology
Etiology
- Exposure to insecticides (organophosphorus compounds)
- Exposure to chemical nerve agents (sarin, soman, tabun, VX)
- Extremely well absorbed from lung, GI tract, skin, mucosa, eyes
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Citation
Schaider, Jeffrey J., et al., editors. "Organophosphate Poisoning." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307572/all/Organophosphate_Poisoning.
Organophosphate Poisoning. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307572/all/Organophosphate_Poisoning. Accessed December 10, 2024.
Organophosphate Poisoning. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307572/all/Organophosphate_Poisoning
Organophosphate Poisoning [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307572/all/Organophosphate_Poisoning.
* Article titles in AMA citation format should be in sentence-case
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T1 - Organophosphate Poisoning
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BT - 5-Minute Emergency Consult
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