From the Guidelines
Organophosphate (OP) poisoning, also known as nerve agent poisoning, typically presents with symptoms of cholinergic syndrome, including narrowed pupils, excessive salivation, bronchoconstriction, mental confusion, convulsions or tremors, and in some cases, death 1.
Common Symptoms
- Dim vision
- Mucous membrane irritation
- Nausea
- Respiratory irritation
- Convulsions or tremors
Severe Symptoms
- Apnea
- Cardiac arrest
- Delayed polyneuropathy These symptoms can occur due to the irreversible inhibition of the enzyme acetylcholinesterase (AChE) by OP compounds, leading to an accumulation of acetylcholine in the nervous system 1.
Treatment
Treatment for OP poisoning often involves the administration of atropine and pralidoxime, which can help alleviate symptoms and reverse the effects of the poisoning 1.
Prevention
Prevention of OP poisoning is crucial, and healthcare workers should take precautions when treating patients who have been exposed to OP compounds, including wearing personal protective equipment and ensuring proper ventilation in the treatment area 1.
From the Research
Symptoms of Organophosphate (OP) Poisoning
The symptoms of OP poisoning can be categorized into several types, including:
- Nicotinic symptoms: fasciculations, neuromuscular paralysis 2
- Muscarinic symptoms: hypersecretions, miosis, rhinorrhea 3, 4
- Central symptoms: status epilepticus, respiratory distress, death 3
- Delayed neurotoxicity: observed in some OP/nerve agents 5, 6
Acute Symptoms
Acute symptoms of OP poisoning include:
- Hypersecretions 3
- Tremors 3
- Status epilepticus 3
- Respiratory distress 3
- Miosis and rhinorrhea: the most common clinical findings in individuals acutely exposed to OP nerve agents 3, 4
Long-term Consequences
Long-term consequences of OP poisoning include:
- Neuropathology: the brain region that shows the most severe damage is the amygdala, followed by the piriform cortex, hippocampus, cortex, thalamus, and caudate/putamen 3
- Neurologic and behavior deficits: documented in recent studies 3
- Structural brain changes: demonstrated on magnetic resonance imaging 3
- Subtle long-term neuropsychological and neurophysiological effects 4
- Organophosphate-induced delayed neuropathy (OPIDN) 4
- Reversible muscular weakness called 'intermediate syndrome' 4