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    Organophosphate Poisoning

    Organophosphate Poisoning is a topic covered in the 5-Minute Emergency Consult.

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    Basics

    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

    • 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

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    TY - ELEC T1 - Organophosphate Poisoning ID - 307572 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307572/all/Organophosphate_Poisoning PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -