Organophosphates Flashcards
(12 cards)
What is the function of AChE ??
- Regulations - the right amount of ACh
- Destruction - destroy ACh after finishing
What are the subsites of AChE??
- Esteratic site
- Anionic site
What is the pathophysiology of organophosphate poisoning??
- Inhibit the ability of AChE to hydrolyze ACh, by binding to the esteratic site of the AChE permanently and make the response for stimulus more aggressive
When did the inhibition of OPC become irreversible??
- 24-36 h without initiation of specific treatment
What is the route of exposure of OPC??
- Through all routs of administration (oral, inhalation, dermal)
Lipid Soluble
What is the clinical picture of OPC poisoning??
- Cholinergic crisis (for days or weeks with good treatment)
- Intermediate syndrome (2-3 days ofter exposure)
- Delayed neuropathy (3-4 weeks post exposure)
- Cardiotoxicity
What is the classical presentation of OPC toxicity??
cholinergic Crisis
What are the causes of relapses of cholinergic crisis ??
bad decontamination
- Redistribution in the body
- Delayed absorption
What are the types of symptoms of cholinergic crisis??
-
Muscarinic effects (DUMBELS)
- early manifestations -
Nicotinic effects (MATCH)
- late manifestations - CNS effects (CNS stimulation then depression)
What is the muscarinic effects of cholinergic crisis??
DUMBELS
1. Diarrhea
2. Urination
3. Miosis (pin pointed pupil)
4. Bradycardia, hypotension, bronchospasm, bronchorrhea
5. Emesis
6. Lacrimation
7. Salivation, sweating
What are thenicotinic effects of cholinergic crisis??
MATCH
1. Muscle fasciculations
- starts around the eyelids and perioral followed by weakness and respiratory paralysis
2. Adrenal medullary hyperactivity
3. Tachycardia, arrhythmia
4. Cramping of skeletal muscles
5. Hypertension
What is the cause of transient hyperglycemia in cholinergic crisis??
Adrenal medullary hyperactivity
