op poisoning and management. nursing. bites and poisoning. nursing college. class presentation.

1. ORGANOPHOSPHATE
POISONING
Submitted To:
Mrs.Narmada
Associate Professor
Department of Medical Surgical Nursing
BCN
Davangere-577004
Submitted by:
Raju Paudel
III year, B.Sc.(N)
BCN
Date:10-12-016
Davangere

2. INTRODUCTION
Organophosphate (OP) compounds
are a diverse group of chemicals
used in both domestic and
industrial settings. Examples of
organophosphates include
insecticides (malathion, parathion,
diazinon, fenthion, dichlorvos,
chlorpyrifos, ethion), nerve gases
(soman, tabun, VX), ophthalmic
agents (echothiophate,
isoflurophate), and antihelmintics
(trichlorfon). Herbicides (tribufos
[DEF], merphos) are tricresyl
phosphate–containing industrial
chemicals.

3. DEFINATION
Organophosphate
poisoning is poisoning due
to organophosphates (OPs).
Organophosphate are used
as insecticides, medications,
and nerve agents.

4. CAUSES
1. Accidental
2. Sucidal
3. Chemical weapons in war
4. During daily use

5. PATHOPHYSIOLOGY
Once an organophosphate binds to AChE, the
enzyme can undergo one of the following:
• Endogenous hydrolysis of the phosphorylated enzyme
by esterases or paraoxonases
• Reactivation by a strong nucleophile such as
pralidoxime (2-PAM)
• Irreversible binding and permanent enzyme inactivation
(aging)
1. The poison is inhaled
2. OP compound inhibits the
ACHE action.
3. Accumulation of Ach.
which activates the
muscarinic and nicotinic
receptors.

6. Clinical
Menifestation•Bronchospasm(wheezing)
•Bronchorrhoea
•Productive cough
•Dyspnoea
•Hypotension
•Bradycardia
•Cardiac arrhythmia
•Diarrhoea
•Vomiting
•Salaivation
•Tenesmus
•Miosis
•Lacrimation
•Blurred visionMuscle weakness
•Fasciculation
•Paralysis
•Muscle twitching

7. Diagnostic Evaluation
•History collection
•Physical examination
•AChE level in blood and urine
•CbC count

8. Rx…
•The mainstays of medical therapy in organophosphate (OP) poisoning include
atropine, pralidoxime (2-PAM), and benzodiazepines (eg, diazepam)
•And other supportive therapies

9. Management
Management of organophosphate poisoning
1. check airway, breathing, circulation.
2. monitor arterial oxygen saturation, cardiac rhythms, BP,
Pulse rate.
3. look for signs & symptoms.
4. obtain IV access.
5. remove the contaminated clothes&wash the skin
thoroughly with soap & water
6. give atropine intravenously as soon as possible for
symptomatic patient
7. perform gastric decontamination with gastric lavage once
the patient is stabilised & within two hours of ingestion.
8. give activated charcoal (50 g in 200 ml)
9. maintainance atropine infusion
10. give pralidoxime .

10. Bibliography
Medical surgical nursing, 2nd edition; BT Basvanthappa.
http://emedicine.medscape.com/
https://en.wikipedia.org

11. Thank you