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]
Myosis is frequently present and when found is almost pathognomonic, especially if associated with other symptoms. Treatment consists essentially of heroic doses of atropine or a similar parasympathetic inhibitor, plus supportive therapy. [pubmed.ncbi.nlm.nih.gov]
[…] 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]
Entire Body System
- Camping
Approximately 300,000 concentration-camp workers passed through I. G. Farben's facilities at Auschwitz and at least 25,000 of them were worked to death. Others were brutally killed in I. G. Farben's drug testing programs. Twelve of I. G. [getipm.com]
[…] beta-N-oxalylamino-L-alanine BOD biochemical oxygen demand BP benzo[a]pyrene BSA bovine serum albumin BSP bromosulfophthalein BUB 2-(3-butylureido)benzimidazole BUN blood urea nitrogen bw body weight CA chrysanthemic acid CALLA common acute lymphoblastic leukaemia antigen cAMP [inchem.org]
- Unconsciousness
Its use in agitated non-compliant patients or un-intubated drowsy or unconscious patients risks major complications including death. [doctorsachin.wordpress.com]
- Fatigue
After some time, the muscles gets fatigued leading to paralysis. [medindia.net]
- Military Personnel
The endpoint of atropine administration is the clearing of bronchial secretions, atropine for field use by military personnel is often loaded in an autoinjector, for ease of use in stressful conditions. [wikivisually.com]
- Crying
[…] ataxia, generalised weakness, coma, convulsions, resp. depression, CVS depression In children CNS effects usually predominated by lethargy or coma/stupor; The predominant symptoms/signs may not be diagnostically useful in young children as: they tend to cry [ozemedicine.com]
Respiratoric
- 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]
Gastrointestinal
- 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 [authorstream.com]
- 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]
The major symptoms are diarrhea, vomiting, pulmonary edema, respiratory difficulty and tonic convulsions. Myosis is frequently present and when found is almost pathognomonic, especially if associated with other symptoms. [pubmed.ncbi.nlm.nih.gov]
GI upset, emesis) and DUMBELS (diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation). [authorstream.com]
GI upset, emesis ) and DUMBELS ( diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation ). 23. [slideshare.net]
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. [authorstream.com]
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]
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]
Cardiovascular
- 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 [authorstream.com]
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
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]
Musculoskeletal
- 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]
Eyes
- Miosis
(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]
[…] 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]
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). [authorstream.com]
urination, diarrhea, GI upset, emesis ) and DUMBELS ( diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation ). 23. [slideshare.net]
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]
- 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. [authorstream.com]
vision, miosis Glands : Increased lacrimation, diaphoresis signs and symptoms include muscle fasciculations, cramping, weakness, and diaphragmatic failure. 25. [slideshare.net]
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]
Neurologic
- 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..: 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]
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]
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]
- Hyporeflexia
Br Med J 1988; 297:918-919. 320) Rayner MD, Popper JS, & Carvalho EW: Hyporeflexia in workers chronically exposed to organophosphate insecticides. [jodrugs.com]
- Lethargy
If highly toxic exposure, pts can quickly (min-hrs) progress to: ataxia, generalised weakness, coma, convulsions, resp. depression, CVS depression In children CNS effects usually predominated by lethargy or coma/stupor; The predominant symptoms/signs [ozemedicine.com]
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
TY - JOUR T1 - [New drugs for etiologic treatment of alkyl phosphate poisoning (tetraethyl pyrophosphate, E 605, etc.)]. [unboundmedicine.com]
Treatment consists essentially of heroic doses of atropine or a similar parasympathetic inhibitor, plus supportive therapy. [pubmed.ncbi.nlm.nih.gov]
Observations on the effects of tetraethyl pyrophosphate (TEPP) in man and on its use in the treatment of myasthenia gravis. Bull. Johns Hopkms Hosp. 1949; 84: 543 Google Scholar Grob D. [amjmed.com]
P321: Specific treatment (see ... on this label). P405: Store locked up. [safe.nite.go.jp]
Circulation 2015; 132(18 Suppl 2):S444-S464. 167) Loddenkemper T & Goodkin HP: Treatment of Pediatric Status Epilepticus. Curr Treat Options Neurol 2011; Epub:Epub. 168) Lotti M: Treatment of acute organophosphate poisoning.. [jodrugs.com]
Prognosis
[…] following as independent factors indicating a poor prognosis [30] : High 6-hour post-admission blood lactate levels Low blood pH Low post-admission 6-hour lactate clearance rates Worldwide mortality studies report mortality rates from 3-25%. [8] The [emedicine.medscape.com]
Clin Pharmacokinet 1990; 18:318-328. 61) Chuang FR, Jang SW, & Lin JL: QTc prolongation indicates a poor prognosis in patients with organophosphate poisoning. [jodrugs.com]
Etiology
TY - JOUR T1 - [New drugs for etiologic treatment of alkyl phosphate poisoning (tetraethyl pyrophosphate, E 605, etc.)]. [unboundmedicine.com]
J Toxicol Clin Toxicol 2002; 40(6):803-816. 154) Keren A, Tzivoni D, & Gavish D: Etiology, warning signs and therapy of torsade de pointes: a study of 10 patients. [jodrugs.com]
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]
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
Whenever people or animals are inadvertently enveloped in such static clouds in the future, their more prompt removal from the area should prevent recurrence of these episodes. [jamanetwork.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]
Prompt recognition and adequate treatment are essential to prevent death. The organic phosphorus radical has the specific effect of inactivating cholinesterase in the body. [pubmed.ncbi.nlm.nih.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]