Citation

King AM, Aaron CK. Emerg. Med. Clin. North Am. 2015; 33(1): 133-151.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.emc.2014.09.010

PMID

unavailable

Abstract

Organophosphates (OPs) and carbamates have a wide variety of applications, most commonly as pesticides used to eradicate agricultural pests or control populations of disease-carrying vectors. Some OP and carbamates have therapeutic indications such as physostigmine. Certain organophosphorus compounds, known as nerve agents, have been employed in chemical warfare and terrorism incidents. Both classes inhibit acetylcholinesterase (AChE) enzymes, leading to excess acetylcholine accumulation at nerve terminals. In the setting of toxicity from either agent class, clinical syndromes result from excessive nicotinic and muscarinic neurostimulation. The toxic effects from OPs and carbamates differ with respect to reversibility, subacute, and chronic effects. Decontamination, meticulous supportive care, aggressive antimuscarinic therapy, seizure control, and administration of oximes are cornerstones of management. © 2015 Elsevier Inc.

Language: en

Keywords

Humans; human; suicide; organophosphate; Poisoning; Review; Antidotes; Environmental Exposure; therapy; envenomation; environmental exposure; Pesticides; intoxication; Organophosphate; vomiting; priority journal; stomach lavage; Alzheimer disease; diazepam; nonhuman; activated carbon; benzodiazepine derivative; seizure; diarrhea; nausea; hypotension; lorazepam; antidote; atropine; unindexed drug; Insecticides; organophosphate pesticide; lung edema; hypertension; occupational hazard; acute toxicity; toxicokinetics; glaucoma; muscle weakness; peripheral neuropathy; organophosphate insecticide; occupational accident; respiratory failure; midazolam; carbamic acid derivative; pralidoxime; Carbamates; carbamate insecticide; bradycardia; bronchospasm; carbamic acid; Atropine; muscarinic receptor blocking agent; muscarinic receptor; Oximes; drug dose titration; myasthenia gravis; oxime; protective equipment; glycopyrronium bromide; disease management; Disease Management; donepezil; rivastigmine; physostigmine; galantamine; tacrine; Oxime; organophosphate poisoning; drug dose escalation; neostigmine; Muscarinic Antagonists; gastric suction; ipratropium bromide; nicotinic receptor; nerve gas; paralytic ileus; cholinesterase inhibition; Carbamate; Organophosphate Poisoning; bronchoconstriction; chemical warfare agent; carbamate poisoning; Chemical warfare; ecothiopate iodide; edrophonium; hazardous waste; LD50; Nerve agents; organic phosphorus induced delayed neuropathy; pyridostigmine; tri ortho cresyl phosphate