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Tetraethyl Pyrophosphate Poisoning

Tepp Poisoning


Presentation

  • Designed specifically with physicians, pharmacologists, and other members of the health care delivery team in mind, the CRC Desk Reference of Clinical Pharmacology features more than 2,000 entries appearing in three formats: Short reviews: these present[books.google.com]
  • This reference guide will be the must-have of any internist or medical professional, as it takes a vast quantity of data across a sweeping grid of disorders, diseases, and presentations, and boils them down to individual parts, facilely indexed, and located[books.google.de]
  • Moreover, as well as the particular solvent (II) used substances able to attack the likewise present in the warfare agents sulfur and phosphorus-containing groups effective as an active nucleophilic components.[google.com.gt]
  • […] medical doctors, dentists, veterinarians, pharmacists, or poisonous/powerful material handling organizations) Pathogens Living pathogens and materials that are proved to contain a living pathogen or carry one on the surface (excluding ones that are presented[post.japanpost.jp]
  • The concentrations in which these compounds cause 50 per cent inhibition of cholinesterase activity and their LD 50 'S in micromols and mgm. per kgm. are presented in tabular form. 2.[jpet.aspetjournals.org]
Physician
  • physician assistants, nurse practitioners and nurses.[books.google.de]
  • Designed specifically with physicians, pharmacologists, and other members of the health care delivery team in mind, the CRC Desk Reference of Clinical Pharmacology features more than 2,000 entries appearing in three formats: Short reviews: these present[books.google.com]
  • Internal Medicine, Division of Hospital Medicine, Mayo Clinic; Vice Chair, Department of Critical Care, ANW Intensivists, Abbott Northwestern Hospital Lisa Kirkland, MD, FACP, FCCM, MSHA is a member of the following medical societies: American College of Physicians[emedicine.medscape.com]
Falling
  • Seite 391 - D poisons, which are known to be so toxic to man as to afford a hazard to health during transportation, or which, in the absence of adequate data on human toxicity, are presumed to be toxic to man because they fall within any one of the following[books.google.de]
  • As the required dose of atropine falls, observation for recurrence of cholinergic features can be done less often (every 2–3 hours).[doctorsachin.wordpress.com]
  • However, the author could not arrive at a single all-encompassing definition of a coenzyme, the study of these cofactors falls under the area of bioinorganic chemistry.[wikivisually.com]
Italian
  • Tetraethylpyrofosfat Tetraethyldifosfat O,O,O,O-Tetraaethyl-diphosphat, bis(O,O-diaethylphosphorsaeure-anhydrid) [German] diethoxyphosphoryl diethyl phosphate Tetraethyl pyrophosphate, liquid Tetraaethylpyrophosphorsaeureester [German] O,O,O,O-Tetraetil-pirofosfato [Italian[molinstincts.com]
Dyspnea
  • Respiratory symptoms include dyspnea (shortness of breath), pulmonary edema, respiratory depression, and respiratory paralysis. Emergency Life-Support Procedures: Acute exposure to TEPP may require decontamination and life support for the victims.[cameochemicals.noaa.gov]
Nausea
  • Frequent early symptoms of tetraethyl pyrophosphate poisoning are dizziness, headache, weakness, muscle twitching, tremor, abdominal cramps, nausea, diarrhea and sweating can develop within 4 12 hours of the contact.[eng.ichacha.net]
  • Adverse effects of pralidoxime: dizziness, headache, nausea, blurred vision, muscle weakness. Patient Disposition: Admit for observation (for 36-72hrs?)[ozemedicine.com]
  • […] symptoms in the patient which can give us the much needed clue of the cause of poisoning Cardiovascular Bradycardia Tachycardia Hypotension Hypertension Respiratory Rhinorrhoea Bronchorrhoea Cough Bronchospasm Respiratory depression Gastrointestinal Nausea[doctorsachin.wordpress.com]
  • Muscarinic effects by organ systems include the following Cardiovascular : Bradycardia, hypotension Respiratory : Rhinorrhea, bronchorrhea, bronchospasm, cough, severe respiratory distress Gastrointestinal : Hypersalivation, nausea and vomiting, abdominal[slideshare.net]
Diarrhea
  • Frequent early symptoms of tetraethyl pyrophosphate poisoning are dizziness, headache, weakness, muscle twitching, tremor, abdominal cramps, nausea, diarrhea and sweating can develop within 4 12 hours of the contact.[eng.ichacha.net]
  • , GI upset, emesis ) and DUMBELS ( diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation ). 23.[slideshare.net]
  • , GI upset, emesis) and DUMBELS (diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation).[authorstream.com]
  • Excessive salivation, nausea, vomiting, anorexia, diarrhea, and abdominal pain may also occur. The heart rate may decrease following oral exposure or increase following dermal exposure. Chest pain may be noted.[cameochemicals.noaa.gov]
Abdominal Pain
  • pain, diarrhea, fecal incontinence Genitourinary : Incontinence Ocular : Blurred vision, miosis Glands : Increased lacrimation, diaphoresis signs and symptoms include muscle fasciculations, cramping, weakness, and diaphragmatic failure. 25.[slideshare.net]
  • pain, diarrhea, fecal incontinence Genitourinary : Incontinence Ocular : Blurred vision, miosis Glands : Increased lacrimation, diaphoresis signs and symptoms include muscle fasciculations, cramping, weakness, and diaphragmatic failure.[authorstream.com]
  • Excessive salivation, nausea, vomiting, anorexia, diarrhea, and abdominal pain may also occur. The heart rate may decrease following oral exposure or increase following dermal exposure. Chest pain may be noted.[cameochemicals.noaa.gov]
Abdominal Cramps
  • Frequent early symptoms of tetraethyl pyrophosphate poisoning are dizziness, headache, weakness, muscle twitching, tremor, abdominal cramps, nausea, diarrhea and sweating can develop within 4 12 hours of the contact.[eng.ichacha.net]
  • cramps Diarrhoea Faecal incontinence Genitourinary Urinary continence Eyes Blurred vision Increased lacrimation Miosis Glands Excessive salivation Lacrimation Sweating General effects Anxiety Restlessness Musculoskeletal Weakness Fasciculations Cramps[doctorsachin.wordpress.com]
Foaming at the Mouth
  • Visible symptoms reported included rolling eyes, foaming at the mouth, and tremors.[theguardian.com]
Hypotension
  • Symptoms and signs of organophosphorus poisoning Whenever OP poisoning is suspected, we must look for the following signs and symptoms in the patient which can give us the much needed clue of the cause of poisoning Cardiovascular Bradycardia Tachycardia Hypotension[doctorsachin.wordpress.com]
  • Stimulation of muscarinic parasymp. receptors: miosis, bronchoconstriction, wheezing, SOB, nausea, vomiting, diarrhoea, tenesmus, fecal incontinence, urinary frequency & incontinence, excessive lacrimation, salivation, broncorrhoea, sweating, bradycardia, hypotension[ozemedicine.com]
  • Muscarinic effects by organ systems include the following Cardiovascular : Bradycardia, hypotension Respiratory : Rhinorrhea, bronchorrhea, bronchospasm, cough, severe respiratory distress Gastrointestinal : Hypersalivation, nausea and vomiting, abdominal[slideshare.net]
  • Hypotension (low blood pressure) may be observed, although hypertension (high blood pressure) is not uncommon. Respiratory symptoms include dyspnea (shortness of breath), pulmonary edema, respiratory depression, and respiratory paralysis.[cameochemicals.noaa.gov]
Chest Pain
  • Chest pain may be noted. Hypotension (low blood pressure) may be observed, although hypertension (high blood pressure) is not uncommon.[cameochemicals.noaa.gov]
Blurred Vision
  • vision Increased lacrimation Miosis Glands Excessive salivation Lacrimation Sweating General effects Anxiety Restlessness Musculoskeletal Weakness Fasciculations Cramps Paralysis Central Nervous System Convulsions Insomnia Dysarthria Tremors Coma Absent[doctorsachin.wordpress.com]
  • Adverse effects of pralidoxime: dizziness, headache, nausea, blurred vision, muscle weakness. Patient Disposition: Admit for observation (for 36-72hrs?)[ozemedicine.com]
  • vision, miosis Glands : Increased lacrimation, diaphoresis signs and symptoms include muscle fasciculations, cramping, weakness, and diaphragmatic failure. 25.[slideshare.net]
  • vision, miosis Glands : Increased lacrimation, diaphoresis signs and symptoms include muscle fasciculations, cramping, weakness, and diaphragmatic failure.[authorstream.com]
  • Signs and Symptoms of TEPP Exposure: Acute exposure to TEPP may produce the following signs and symptoms: sweating, pinpoint pupils, blurred vision, headache, dizziness, profound weakness, muscle spasms, seizures, and coma.[cameochemicals.noaa.gov]
Miosis
  • […] nicotinic effects, and ( 3 ) CNS effects. 1- Mnemonic devices used to remember the muscarinic effects of organophosphates are SLUDGE ( salivation, lacrimation, urination, diarrhea, GI upset, emesis ) and DUMBELS ( diaphoresis and diarrhea; urination; miosis[slideshare.net]
  • (2) nicotinic effects, and (3) CNS effects. 1- Mnemonic devices used to remember the muscarinic effects of organophosphates are SLUDGE (salivation, lacrimation, urination, diarrhea, GI upset, emesis) and DUMBELS (diaphoresis and diarrhea; urination; miosis[authorstream.com]
  • Respiratory Rhinorrhoea Bronchorrhoea Cough Bronchospasm Respiratory depression Gastrointestinal Nausea/vomiting Increased salivation Abdominal cramps Diarrhoea Faecal incontinence Genitourinary Urinary continence Eyes Blurred vision Increased lacrimation Miosis[doctorsachin.wordpress.com]
  • Clinical effects of acute exposure: Stimulation of muscarinic parasymp. receptors: miosis, bronchoconstriction, wheezing, SOB, nausea, vomiting, diarrhoea, tenesmus, fecal incontinence, urinary frequency & incontinence, excessive lacrimation, salivation[ozemedicine.com]
  • There was at least one image of a child suffering miosis, the pin-point pupil effect associated with the nerve agent sarin, a powerful neurotoxin reportedly used before in Syria.[theguardian.com]
Lacrimation
  • , urination, diarrhea, GI upset, emesis ) and DUMBELS ( diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation ). 23.[slideshare.net]
  • , urination, diarrhea, GI upset, emesis) and DUMBELS (diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation).[authorstream.com]
  • Miosis Glands Excessive salivation Lacrimation Sweating General effects Anxiety Restlessness Musculoskeletal Weakness Fasciculations Cramps Paralysis Central Nervous System Convulsions Insomnia Dysarthria Tremors Coma Absent reflexes [doctorsachin.wordpress.com]
  • Clinical effects of anticholinesterase poisoning: Classically, symptoms develop over a few hours (less if massive exposures or up to 2days if lipophilic) and present as the “SLUDGE” syndrome : Salivation, Lacrimation, Urination, Diarrhoea, GIT effects[ozemedicine.com]
  • Soon after, the victim will then have difficulty breathing and will experience nausea, as the victim continues to lose control of their bodily functions, they will involuntarily salivate, lacrimate, urinate, defecate, and experience gastrointestinal pain[wikivisually.com]
Muscle Twitch
  • Frequent early symptoms of tetraethyl pyrophosphate poisoning are dizziness, headache, weakness, muscle twitching, tremor, abdominal cramps, nausea, diarrhea and sweating can develop within 4 12 hours of the contact.[eng.ichacha.net]
  • twitching/fasciculations, weakness CNS effects if penetrate BBB: emotional lability, restlessness, tremors, headaches, withdrawal & depression, drowsiness, lethargy If highly toxic exposure, pts can quickly (min-hrs) progress to: ataxia, generalised[ozemedicine.com]
Muscle Cramp
  • cramps, altered gait, drowsiness, emotional lability, depression, irritability.[ozemedicine.com]
Seizure
  • Diazepam is used to control seizures caused due to the poisoning.[medindia.net]
  • Syrup of Ipecac should be administered only if victims are alert, have an active gag reflex, and show no signs of impending seizure or coma.[cameochemicals.noaa.gov]
  • Cont.. 2- Autonomic nicotinic effects include hypertension, tachycardia, mydriasis, and pallor. 3- CNS effects include anxiety, emotional lability, restlessness, confusion, ataxia, tremors, seizures, and coma. 26.[slideshare.net]
  • Cont..: Cont.. 2- Autonomic nicotinic effects include hypertension, tachycardia, mydriasis, and pallor. 3- CNS effects include anxiety, emotional lability, restlessness, confusion, ataxia, tremors, seizures, and coma.[authorstream.com]
  • Complications include severe bronchorrhea, seizures, weakness, and neuropathy. Respiratory failure is the most common cause of death. Age Organophosphates (OPs) may affect children or other at-risk populations differently.[emedicine.medscape.com]
Headache
  • Frequent early symptoms of tetraethyl pyrophosphate poisoning are dizziness, headache, weakness, muscle twitching, tremor, abdominal cramps, nausea, diarrhea and sweating can develop within 4 12 hours of the contact.[eng.ichacha.net]
  • Adverse effects of pralidoxime: dizziness, headache, nausea, blurred vision, muscle weakness. Patient Disposition: Admit for observation (for 36-72hrs?)[ozemedicine.com]
  • Signs and Symptoms of TEPP Exposure: Acute exposure to TEPP may produce the following signs and symptoms: sweating, pinpoint pupils, blurred vision, headache, dizziness, profound weakness, muscle spasms, seizures, and coma.[cameochemicals.noaa.gov]

Workup

  • See Workup. Treatment begins with decontamination. Airway control and oxygenation are paramount. The mainstays of pharmacological therapy include atropine, pralidoxime (2-PAM), and benzodiazepines (eg, diazepam).[emedicine.medscape.com]

Treatment

  • P321: Specific treatment (see ... on this label). P405: Store locked up.[safe.nite.go.jp]
  • Sarin gas, as therapeutic agents, such as ecothiopate used in the treatment of glaucoma, and as household chemicals.[doctorsachin.wordpress.com]
  • Treatment : Treatment Atropine can be used as an antidote in conjunction with pralidoxime, though the use of "-oximes" has been found to be of no benefit, or possibly harmful, in at least two meta-analyses.[authorstream.com]
  • See Treatment and Medication. Background Organophosphate compounds were first synthesized in the early 1800s when Lassaigne reacted alcohol with phosphoric acid.[emedicine.medscape.com]
  • Treatment Atropine can be used as an antidote in conjunction with pralidoxime, though the use of "-oximes" has been found to be of no benefit, or possibly harmful, in at least two meta-analyses.[slideshare.net]

Epidemiology

  • Although most patients rapidly become symptomatic, the onset and severity of symptoms depend on the specific compound, amount, route of exposure, and rate of metabolic degradation. [5] Epidemiology Frequency United States In 2016, the American Association[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology : Pathophysiology The primary mechanism of action of organophosphate pesticides is inhibition of carboxyl ester hydrolases, particularly acetylcholinesterase (AChE).[authorstream.com]
  • […] odacheis Acetylcholinesterase inhibitor poisoning Organophosphate & Carbamate Insecticide Poisoning: Pathophysiology: Both organophosphate & carbamate insecticides are acetylcholinesterase inhibitors which are readily absorbed through intact skin or mucosa[ozemedicine.com]
  • Pathophysiology The primary mechanism of action of organophosphate pesticides is inhibition of carboxyl ester hydrolases, particularly acetylcholinesterase ( AChE ).[slideshare.net]
  • These have included difficulties in executive functions, psychomotor speed, verbal, memory, attention, processing speed, visual-spatial functioning, and coordination. [4] Pathophysiology The primary mechanism of action of organophosphate pesticides is[emedicine.medscape.com]

Prevention

  • Chemistry heat hydrogen implementation improve increase Industrial Ecology industry input installed Kalundborg kiln lignin liquid manufacturing measures membrane mercury metals mill nitrogen operation optimisation organisation oxides oxygen ozone Pollution Prevention[books.google.com]
  • Wear gloves or other protective clothing when gardening to prevent contact with plants that have pesticides on them.[babygooroo.com]
  • (ERG, 2016) Protective Clothing Skin: Wear appropriate personal protective clothing to prevent skin contact. Eyes: Wear appropriate eye protection to prevent eye contact.[cameochemicals.noaa.gov]
  • Organophosphorus compounds block this enzyme, thus preventing the breakdown of acetylcholine. Thus acetlycholine acts for an excessively long time causing symptoms like twitches and increased secretions.[medindia.net]
  • He was aware of the toxic signs produced by these esters and, while the potency of some of these chemicals prevented their development and use as "insecticides", they were of immediate interest to the German Ministry of Defense which recognized their[getipm.com]

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