Organo phosphate poisoning

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Organo phosphate poisoning

  1. 1. ORGANOPHOSPHATE POISONING<br />
  2. 2. Organophosphate poisoning <br />Basis of organophosphate poisoning<br />Clinical features<br />Treatment <br />
  3. 3. Organophosphates<br />What are Organophosphates?<br /> group of potent nerve agents, functioning by inhibiting the enzyme acetyl cholinesterase<br />Examples :-<br />
  4. 4. Mechanism of organophosphate poisoning<br />Organophosphates inactivate AChE by phosphorylating the serine hydroxyl group located at the active site of AChE. <br />The phosphorylation occurs by loss of an organophosphate leaving group and establishment of a covalent bond with AChE.<br />
  5. 5. Mechanism of organophosphate poisoning<br />
  6. 6. increase and accumulation of acetylcholine at nerve endings, stimulating neuro- effecter junctions, skeletal neuro- muscular junctions, autonomic ganglia and in the brain.<br />AChaccumulates throughout the nervous system, resulting in overstimulation of muscarinic and nicotinic receptors<br />Overstimulation causes a depolarising block of neuromuscular junction receptors.<br />
  7. 7. Mechanism of organophosphate poisoning<br />Acetyl cholinesterase<br />Acetyl choline<br />Depolarizing Block<br />
  8. 8.
  9. 9. Sign & Symptoms<br />divided into <br />Muscarnic effects<br />Nicotinic effects<br />CNS effects<br />
  10. 10. Muscarinic effects by organ systems include the following:<br />Cardiovascular- Bradycardia, hypotension<br />Respiratory - Rhinorrhea, bronchorrhea, bronchospasm, cough, severe respiratory distress<br />Gastrointestinal - Hypersalivation, nausea and vomiting, abdominal pain, diarrhea.<br />Genitourinary - Incontinence<br />Ocular - Blurred vision, miosis<br />Glands - Increased lacrimation, diaphoresis<br />
  11. 11. Nicotinic signs and symptoms <br /> muscle fasciculations, cramping, weakness, and diaphragmatic failure. <br />CNS effects <br /> anxiety, emotional liability, restlessness, confusion, ataxia, tremors, seizures, and coma.<br />
  12. 12. Poisoning may follow ingestion, inhalation or dermal absorption<br />At first<br />Person feels sick<br />Complains of headache<br />General weakness or tiredness<br />Then<br />Person begins to sweat and salivate, may vomit and diarrhea<br />stomach cramps<br />Pupils (of the eyes) become very small<br />
  13. 13. Blurred vision<br />Muscle twitch and hand shake<br />Breathing becomes bubbly<br />Person has a fit and unconscious<br />
  14. 14. Treatment<br />Atropine<br /> block muscarinic effects due to excessive acetylcholine<br /> 0.6-2 mg should be given to reduce bronchorrhoea and rhinorrhoea, together with an oxime, such as pralidoxime<br />
  15. 15. Pralidoxime (2-PAM)<br />Nucleophilic agent that reactivates the phosphorylatedAChE by binding to the OP molecule<br />not effective once the OP compound has bound AChEirreversibly<br />Recommendation - administration within 48 h of OP poisoning<br />Administered by slow injection or as an infusion.<br />
  16. 16. THANK YOU<br />

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