Clinical features of organophosphate poisoning: a review of different classification systems and approaches
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TLDR
Different approaches to the symptoms and signs in OP poisoning may better the understanding of the underlying mechanism that in turn may assist with the management of acutely poisoned patients.Abstract:
PURPOSE: The typical toxidrome in organophosphate (OP) poisoning comprises of the Salivation, Lacrimation, Urination, Defecation, Gastric cramps, Emesis (SLUDGE) symptoms. However, several other manifestations are described. We review the spectrum of symptoms and signs in OP poisoning as well as the different approaches to clinical features in these patients. MATERIALS AND METHODS: Articles were obtained by electronic search of PubMed(®) between 1966 and April 2014 using the search terms organophosphorus compounds or phosphoric acid esters AND poison or poisoning AND manifestations. RESULTS: Of the 5026 articles on OP poisoning, 2584 articles pertained to human poisoning; 452 articles focusing on clinical manifestations in human OP poisoning were retrieved for detailed evaluation. In addition to the traditional approach of symptoms and signs of OP poisoning as peripheral (muscarinic, nicotinic) and central nervous system receptor stimulation, symptoms were alternatively approached using a time-based classification. In this, symptom onset was categorized as acute (within 24-h), delayed (24-h to 2-week) or late (beyond 2-week). Although most symptoms occur with minutes or hours following acute exposure, delayed onset symptoms occurring after a period of minimal or mild symptoms, may impact treatment and timing of the discharge following acute exposure. Symptoms and signs were also viewed as an organ specific as cardiovascular, respiratory or neurological manifestations. An organ specific approach enables focused management of individual organ dysfunction that may vary with different OP compounds. CONCLUSIONS: Different approaches to the symptoms and signs in OP poisoning may better our understanding of the underlying mechanism that in turn may assist with the management of acutely poisoned patients. Language: enread more
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Neurotoxicity in Preclinical Models of Occupational Exposure to Organophosphorus Compounds.
TL;DR: It is found that animal studies simulating occupational OP exposures do indeed show evidence of neurotoxicity, and that utilization of these models is helping illuminate the mechanisms underlying OP-induced neurological sequelae.
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Toxicology of organophosphorus compounds in view of an increasing terrorist threat
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References
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Management of Acute Organophosphorus Pesticide Poisoning
Michael Eddleston,Michael Eddleston,Nicholas A. Buckley,Peter Eyer,Peter Eyer,Andrew H. Dawson +5 more
TL;DR: It is suggested that early resuscitation with atropine, oxygen, respiratory support, and fluids is needed to improve oxygen delivery to tissues, such that bans on particular pesticides could be the only method to substantially reduce the case fatality after poisoning.
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Neurotoxic effects of organophosphorus insecticides. An intermediate syndrome.
TL;DR: Patients appeared to have a distinct clinical entity that developed after the acute cholinergic crisis and before the expected onset of the delayed neuropathy, and this neuromuscular junctional defect may have been the predominant cause of the paralytic symptoms.
Journal ArticleDOI
Muscarinic receptors: their distribution and function in body systems, and the implications for treating overactive bladder
Paul Abrams,Karl-Erik Andersson,Jerry J. Buccafusco,Christopher R. Chapple,William C. de Groat,Alison D. Fryer,Gary Kay,Alan M. Laties,Neil M. Nathanson,Pankaj J. Pasricha,Alan J. Wein +10 more
TL;DR: The evolving understanding of muscarinic receptor functions throughout the body is explored, with particular focus on the bladder, gastrointestinal tract, eye, heart, brain and salivary glands, and the implications for drugs used to treat OAB.
Journal ArticleDOI
Differences between organophosphorus insecticides in human self-poisoning: a prospective cohort study
Michael Eddleston,Michael Eddleston,Peter Eyer,Franz Worek,Fahim Mohamed,Lalith Senarathna,Ludwig von Meyer,Edmund Juszczak,Ariyasena Hittarage,Shifa Azhar,Wasantha Dissanayake,M H Rezvi Sheriff,Ladislaus Szinicz,Andrew H. Dawson,Nicholas A. Buckley +14 more
TL;DR: Organophosphorus insecticide poisoning is not a single entity, with substantial variability in clinical course, response to oximes, and outcome and, consequently, patients might benefit from management protocols developed for particular organoph phosphorus insecticides.
Journal ArticleDOI
Muscle and neuronal nicotinic acetylcholine receptors
Dimitra Kalamida,Konstantinos Poulas,Konstantinos Poulas,Vassiliki Avramopoulou,Efrosini Fostieri,George Lagoumintzis,Konstantinos Lazaridis,Anastasia Sideri,Marios Zouridakis,Marios Zouridakis,Socrates J. Tzartos,Socrates J. Tzartos +11 more
TL;DR: Nicotinic acetylcholine receptors (nAChRs) as mentioned in this paper are integral membrane proteins and prototypic members of the ligand-gated ion-channel superfamily, which has precursors in the prokaryotic world.