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Organophosphate (Cholinergic) Poisoning

Organophosphates inhibit acetylcholinesterase causing severe cholinergic crisis.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Organophosphate (Cholinergic) Poisoning?

Organophosphate and carbamate pesticides reversibly or irreversibly inhibit acetylcholinesterase causing acetylcholine accumulation at synapses. Due to widespread use in agriculture, intentional or accidental poisoning is common in developing countries.

The clinical picture is a mix of muscarinic (SLUDGE: salivation, lacrimation, urination, defecation, GI cramps, vomiting), nicotinic (muscle fasciculation, weakness, paralysis) and central (confusion, convulsion, coma) findings.

Treatment includes; decontamination, suppression of muscarinic findings with atropine titration and enzyme reactivation with pralidoxime. Late complications such as intermediate syndrome and delayed polyneuropathy require monitoring.

Symptoms

Excessive salivation and lacrimation
Nausea, vomiting and abdominal cramps
Sweating, miosis and bronchospasm
Muscle fasciculation and weakness
Bradycardia and hypotension
Altered consciousness, convulsion and coma

Risk Factors

Agricultural work and spraying exposure
Pesticide storage accidents
Intentional poisoning and suicide attempt
Lack of protective equipment
Contaminated food or water intake
Accidents in home environment in children

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Call 112 in any suspected organophosphate exposure
  • Contaminated clothing should be removed and skin washed with plenty of water
  • Rescuers should use protective equipment
  • 72-hour observation is required for intermediate syndrome

Treatment Methods

01
Decontamination (removing clothes, washing skin)
02
Airway safety and oxygenation
03
Atropine titration (until secretions dry)
04
Pralidoxime (2-PAM) in early period
05
Benzodiazepine in convulsion
06
Long-term monitoring and organ support in intensive care

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.