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Organophosphate poisoning

Introduction
• Carbamates and organophosphates are
inhibitors of cholinesterase enzymes.
• They are commonly used in insecticides and
pesticides and children are exposed
accidentally in the house/farm. Common
types are diazinon, malathion, dichlorvos
• Nerve gas agents used in warfare are also
organophosphates. E.g. sarin
• Worldwide mortality is 3-25%

Pathophysiology
• These toxins bind to cholinesterase which results
in prevention of acetylcholine degradation hence
its accumulation at nerve synapses.
• Cholinesterase enzyme is found in red blood cells,
plasma and nerves.
• Organophosphate binding if not treated results in
a permanent bond usually fro 18 – 72 hrs (aging)
carbamate bonds are temporary.
• Regeneration of inactivated enzymes requires
weeks.

Clinical...