OP Poisoning routes, pathophysiology, diagnosis, sludge syndrome, effects on different systems, symptoms and severity, goals of treatment, decontamination and treatment

1. Organophosphate
poisoning

2.  Inhalation
 Ingestion
Dermal contact

3. Pathophysiology
• Organophosphates share structural similarity with
acetylcholine and binds covalently with cholinesterase
molecule, leads to accumulation of acetylcholine at
synapses causes overstimulation in CNS and PNS.

4. activity are used for confirming
• OP poisoning has toxicological effects on body systems
1. Cardiovascular system
2. Respiratory system
3. Neurological system
4. Endocrine system

5. Death from acute severe poisoning occurs due to respiratory
compromise.
Most Significant muscuranic effects are and
Respiratory depression

6. suggests

7. SLUDGE SYNDROME
 alivation
 acrimation
 rination
 efecation
 astric Cramps
 mesis

8. • OP poisoning has effects on reproductive and nervous
system
Reproductive effects :
- In Men, exposure to OP has poor semen and sperm
quality, decreased seminal volume and % of motility,
decreased sperm count per ejaculate.
- Prenatal exposure leads to impaired fetal growth and
development.

9. Neurotoxic Effects
1.Cholinergic syndrome
2.Intermediate syndrome
3.OP-induced delayed polyneuropathy
4.Chronic OP induced delayed polyneuropathy

10. OP POISONING - SYMPTOMS & LEVEL OF TOXICITY
MILD MODERATE SEVERE
Shortness of breath
Limitation of activity
Coughing
Lacrimation
Bradycardia
Sweating
Runny nose
Colic pain
Diarrhea
Vomiting
Restlessness
Weakness
Pallor
Altered consciousness
Muscle twitching
Convulsions
Respiratory failure
Pulmonary edema
Paralysis
Cyanosis
Deep coma

11. GOALS OF TREATMENT
 Reduce absorption of toxins
Enhance elimination
Neutralise toxins already present in the body

12. DECONTAMINATION
1. Remove all clothing and gently cleanse patient.
2. Use personal protective equipment i.e., Neoprene
gloves and gowns
3. Use charcoal catridge masks for respiratory protection
when decontaminating patients who are significantly
contaminated.
4. Irrigate eyes of patient who had ocular exposure using
normal saline.

13. TREATMENT
• Atropine remains the mainstay of therapy as it dries up
respiratory secretions and getting bronchial muscles to
relax.
1.Atropine :To reverse cholinergic activity, improve
cardiac and respiratory functions
2.Clonidine :Decreases HR in tachycardia
3. Pralidoxime :Antidote for OP poisoning
4. Sodium bicarbonate :For alkalisation and correcting
metabolic acidosis

14. 5. Magenesium sulfate :On first day of admission
6. Benzodiazepines :Provide sedation, To controll
agitations and seizures
7. Cathartics :Decrease absorption of substances by
expulsion of poison from GI tract
8. Sodium bicarbonate :for alkalisation and correcting
metabolic acidosis
9. Glycopyruvate :Given along with atropine