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ORGANOPHOSPHATEPOISONING
Dr pramod sarwa
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INTRODUCTION
• Organophosphate widely used in agricultural sector as PESTICIDES.
• Nerve agents sarin, tabun, soman, VX, VE• Mortality a/w self-poisoning with pesticides:– 50-70 % in developing world– 0.3 % in developed world , jrccth
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classification
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PHYSIOLOGY REVISITED
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MECHANISM OF ACTION OF ORGANOPHOSPATE POISONING
Irreversibly bind to serine-OH group at the active site of acetylcholinesterase (AChE) establish covalent bond (phosphorylation)
↓AGING: loss of alkyl group + strengthening of
covalent bond↓
Phosphorylated AChE is very stable↓
Inhibition of enzyme activity accumulation of ACh in the synapse and NMJ
↓Overstimulation of cholinergic receptors
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CLINICAL PRESENTATION
MUSCARINIC: SLUDGES-SalivationL-LacrimationU-UrinationD-DiarrhoeaG-GI upsetE-Emesis
NICOTINIC: MATCHM-Muscle weakness
and fasciculationA-Adrenal medulla
activity ↑T-TachycardiaC-Cramping of skeletal
muscleH-Hypertension
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