ORGANOPHOSPHORUS

POISIONING

BY
S.POORNIMA
INTRODUCTION
SARIN GAS
TREATMENT OF GLAUCOMA
PESTICIDE
AVAILABLE OVER THE COUNTER
SUICIDE
WHO-1 million ACCIDENTAL POSIONING
2 million SUICIDE ATTEMPTS
TYPES

ORGANOPHOSPHOROUS

HIGHLY TOXIC INTERMEDIATELY TOXIC LOW TOXIC

(PARATHION) (TRICHLORFON) (MALATHION)
MECHANISM OF ACTION
 INHIBITOR OF CHOLINESTERASE

OVER STIMULATION OF MUSCARINIC AND

NICOTINIC RECEPTORS

DISRUPTS TRANSMISSION OF NERVE

IMPULSE IN CNS
PHARMACOKINETICS
LIPID SOLUBLE
ABSORPTION
SKIN
ORAL MUCOUS MEMBRANE
CONJUNCTIVA
GIT
RESPIRATORY TRACT
CROSSES BLOOD BRAIN BARRIER
METABOLISM IN LIVER
ELIMINATION – URINE, BILE, FAECES
CLINICAL FEATURES
SYMPTOMS AND SIGNS OF
ORGANOPHOSPHOROUS POISIONING

MUSCARINIC RECEPTORS
CARDIO VASCULAR
Bradycardia
Hypotension
RESPIRATORY
Rhinorrhoea
Bronchorrhoea
Bronchospasm
Cough
GASTROINTESTINAL
Nausea/vomiting
Increased salivation
Abdominal cramps
Diarrhoea
Faecal incontinence
GENITOURINARY
Urinary continence
EYES
Blurred vision
Increased lacrimation
Miosis
GLANDS
Excessive salivation
NICOTINIC RECEPTORS

CADRIOVASCULAR
Tachycardia
Hypertension
MUSCULOSKELETAL
Weakness
Fasciculations
Cramps
Paralysis
CENTRAL RECEPTORS

General effects
Anxiety
Restlessness
Ataxia
Convulsions
Insomnia
Dysarthria
Tremors
Coma
Absent reflexes
Respiratory depression
Circulatory collapse
CARDIAC MANIFESTATIONS

PHASE I- A BRIEF PERIOD OF INC.

SYMPATHETIC TONE
PHASE II- PROLONGED PERIOD OF
PARASYMPATHETIC ACTIVITY
INCLUDING AV NODE BLOCKADE
PHASE III- QT PROLONGATION
NEUROLOGICAL MANIFESTATIONS

TYPE I PARALYSIS - ACUTE

TYPE II PARALYSIS – INTERMEDIATE
SYNDROME
TYPE III PARALYSIS – DELAYED
POLYNEUROPATHY
DIAGNOSIS
HIGH INDEX OF SUSPICION
PUNGENT GARLIC LIKE ODOUR
MIOSIS
BRADYCARDIA
MUSCLE FASCICULATIONS
INCREASED SECRETIONS
BLOOD INVESTIGATION –
TRUE AND PSEUDOCHOLINESTERASE
LEVEL DECREASED
MANAGEMENT
Skin decontamination
Airway protection if indicated
Gastric lavage
Activated charcoal 0.5-1gm/kg every 4hr
Anticholinesterase: Atropine/glycopyrrolate
Cholinesterase reactivator: Pralidoxine
Ventilatory support
Inotropic support
Feeding-enteral/parental
PREVENTION

IMPROVED REGULATION OF THE

AVAILABILITY
STRICT REGULATION OF VENDORS
MODIFICATION AND PACKAGING
BETTER AVAILABILITY OF ANTIDOTE
SAFE STORAGE
PROPER PRECAUTION WHILE USAGE
THANK YOU!