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Controversies in the management of organophosphate pesticide poisoning

Bairy, KL and Vidyasagar, Sudha and Sharma, Alok and Sammad, V (2007) Controversies in the management of organophosphate pesticide poisoning. Organophosphate poisoning, 39 (2). pp. 71-74.

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Abstract

Acute poisoning with organophosphorous (OP) pesticides frequently causes ill-health and death allover the world. The treatment of OP poisoning is primarily aimed at reversing the effects of the compound by administration of atropine. A second class of compounds-oximes, capable of regenerating the active enzyme from the OP-cholinesterase complex, is also available to treat OP poisoning. Pralidoxime is the oxime most often used worldwide. The low propensity to aging with diethyl organophosphorous poisoning may allow reactivation of the acetylcholinesterase after several days, when the poison concentration drops. The usefulness of oximes has however been challenged over the past 20 years by physicians in many parts of the world who have failed to see any benefit in their clinical practice. We have carried out a systematic search to find clinical trials, both randomized and nonrandomized involving the management of OP poisoning. The clinical benefits of oximes in OP poisoning is not clear, being limited by the type of OP, poison load, time to start therapy and dose of oximes. Hence, one is left with a doubt as to whether one could use oximes at all in OP poisoning? A high-quality randomized clinical trial on a large number of subjects comparing the current World Health Organization-recommended regimen with a placebo to assess the value of pralidoxime in acute OP poisoning, may answer the above question.

Item Type: Article
Uncontrolled Keywords: Clinical trials, organophosphate poisoning, pralidoxime
Subjects: Medicine > KMC Manipal > Medicine
Medicine > KMC Manipal > Pharmacology
Depositing User: KMC Manipal
Date Deposited: 22 Feb 2012 06:53
Last Modified: 22 Feb 2012 06:53
URI: http://eprints.manipal.edu/id/eprint/3225

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