Catalog

Abstract --Organophosphate compounds are potent inhibitors of cholinesterase; most of these compounds are used as insecticides, pesticides, or drugs. Like many other countries, poisoning with organophosphate compounds is one of the most important causes of intoxication in Taiwan. Manifestations depend on the agent and its concentration. The mode of contact in organophosphate poisoning varies, as these compounds are absorbed efficiently by oral, dermal, conjunctival, gastrointestinal, and respiratory routes. Organophosphates strongly inhibit both true acetylcholinesterase and pseudocholinesterase which leads to accumulation of acetylcholine at the synapses. As a result, muscarinic and nicotinic symptoms appear. The onset of the signs and symptoms of organophosphate poisoning varies with the route and degree of exposure. Treatment of poisoning with organophosphate is directed toward four goals: (1) decontamination, (2) supportive care, (3) reversal of acethylcholine excess at muscarinic sites, and (4) reversal of toxin binding at active sites on the cholinesterase molecule. Due to potential prolonged effects of acetylcholinesterase inhibition, most individuals with significant exposures require hospital admission and regular follow up.