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Organophosphate Poisoning and Treatment with Atropine

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Postganglionic cholinergic receptors, including receptors found in gastrointestinal and pulmonary smooth muscle, exocrine glands, heart, and eye (Katz & Brooks, 2006). Glycopyrrolate- is an antimuscarinic agent, which reduces salivary, tracheobronchial, and pharyngeal secretions (Katz & Brooks, 2006. Oximes- these are nucleophilic agents that are capable of reactivating the phosphorylated AChE by binding to the organophosphate molecule. However, these agents are not effective after the organophosphate compound has irreversibly bound with AChE (Katz & Brooks, 2006. Diazepam-acts by increasing the activity of gamma-aminobutyrate (GABA) and facilitates inhibitory GABA neurotransmission, and is, therefore, used in the treatment of seizures (Katz & Brooks, 2006.

Bioscavengers-human serum butyrylcholinesterase (Hu BChE)-“ sequesters highly toxic organophosphates before they reach their physiological targets” (Saxena et al. Galantamine-acts both as a “ reversible competitive inhibitor of acetylcholinesterase (AChE) and as an allosteric modulator of nicotinic acetylcholine receptors” (Zarotsky, Sramek, Cutler, 2003. Pyridostigmine bromide-reversibly inhibits AChE and BuChE (Albuquerque et al. , 2006) and therefore, allows normal transmission of nerve impulses across the neuromuscular junction. (Daily Med, 2007. Atropine toxicity- agitation, confusion, urinary retention, hyperthermia, bowel ileus, and tachycardia (Eddleston et al.

Glycopyrrolate-tachycardia, dry mouth, and ileus. Oximes-dizziness, drowsiness, headache, tachycardia, blurred vision, diplopia, impaired accommodation, nausea, muscular weakness, hyperventilation, and pain at injection site. Diazepam-respiratory depression (Eddleston, Singh, Buckley, 2007). Galantamine-Nausea, vomiting, diarrhea, and dizziness. Less frequently it causes anorexia, headache, weight loss, and depression (Zarotsky, Sramek, Cutler, 2003). Pyridostigmine bromide-nausea, vomiting, diarrhea, abdominal cramps, increased peristalsis, increased salivation, increased bronchial secretions, miosis, and diaphoresis, muscle cramps, fasciculation and weakness

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