Acute Organophosphate Poisoning in University Hospital Emergency Room Patients

Yürümez, Yusuf; Durukan, Polat; Yılmaz, Yücel; Ikizceli, İ̇brahim; Avşaroğulları, Levent; Özkan, Seda; Akdur, Okhan; Özdemir, Çağlar

doi:10.2169/internalmedicine.46.6304

Cited by 98 publications

(84 citation statements)

References 25 publications

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“…This finding is consistent with those reported by Yurumez et al, and that of Chedi and Aliyu. 13,14 Though the centrally acting α2-adrenergic receptor agonists such as clonidine can reduce Ach synthesis and release in pre-synaptic junction and has a protective effect against the centrally acting AchE, but in our study the rats which received only clonidine has shown significant (p<0.05) improvement central effects only for straubs tail and whole body tremors compared to that of control and atropine with clonidine group. But our study results are similar with the study by Buccafusco and Aronstam 1986 that pre-treatment with clonidine protected against several of the centrally-mediated toxic effects of soman.…”

Section: Discussioncontrasting

confidence: 63%

Preclinical study comparing the antidotal effect of clonidine with atropine for the treatment of acute malathion poisoning in the albino rats

Suresha

SantoshKumar

Nagashayana³

2016

Int J Basic Clin Pharmacol

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Background: In developing countries 2–3 million people are acutely poisoned by organophosphorus (OP) pesticides every year. There is a pressing need for new affordable antidotes and in this context clonidine which has central effect (α2 agonist) has been evaluated in the albino rats presenting with signs or symptoms of acute malathion poisoning. And compared with atropine for the acte malathion poisoning in albino rats.Methods: This was a preclinical study conducted on albino rats of either sex weighing 100-150 grams were randomly divided into 4 groups (6/group). Malathion was given at the lethal dose of 54 mg/kg body weight (BW) by gavage to each group. Group 1: normal saline intraperioneal (i.p). Group 2: Post treated with atropine 1.5 mg/kg BW (i.p). Group 3: Pre treated with clonidine 1mg/ kg BW (i.p), 10 minutes priore malathion. Group 4: Pre treated with clonidine and post treated with atropine. The above groups were observed for straub tail, muscle fasciculation, piloerection, lacrimation, defecation/ urination; salivation, tremors, gasping and convulsion and were recorded at time 0, 15, 30, 45 and 60 minutes after poisoning. The latency of onset of tremors, loss of righting reflex and tremors were recorded. Results were presented as percentage occurrence and Mean ± SEM. Repeated measure one way ANOVA and Fisher’s Least Significant Difference post hoc test for comparison between groups. P-value of 0.05 or less was considered for statistical significance.Results: The central effects namely straubs tail and whole body tremors are significantly improved compared to control and atropine with clonidine group (p<0.05). However convulsion shows improve in atropine alone and atropine with clonidine groups. The overall survival time has significantly increased compared to control and atropine and atropine with clonidine (P<0.05).Clonidine has not shown any effect on survival time.Conclusions: Clonidine has some central protective effect in malathion poisoning. And it has not shown any effect on survival time. This issue needs further controlled studies.

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Section: Discussioncontrasting

confidence: 63%

Preclinical study comparing the antidotal effect of clonidine with atropine for the treatment of acute malathion poisoning in the albino rats

Suresha

SantoshKumar

Nagashayana³

2016

Int J Basic Clin Pharmacol

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“…Yurumez et al (17) and Seydaoglu (21) It is said that necrotizing pancreatitis (25), coital-like involuntary movements (26) and intermediary syndrome may develop in patients after OP poisoning (27,28). In our series these complications were not seen.…”

Section: Methodsmentioning

confidence: 46%

Organophosphate Poisoning Due to a Wheat Bagel

Kavalcı¹,

Durukan

Özer³

et al. 2009

Intern. Med.

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“…Two major mechanisms in acute organophosphate poisoning, cholinergic syndrome and increased oxidative stress, lead to increased leukocyte counts in the body. Experimental and clinical studies have reported that leukocyte counts are increased in organophosphate poisoning (3,10,20,21). In a few clinical studies, it was reported that leukocytosis could be used as a prognostic parameter for predicting the severity of organophosphate poisoning (3,23,24).…”

Section: Mechanically Ventilatedmentioning

confidence: 99%

“…Experimental and clinical studies have reported that leukocyte counts are increased in organophosphate poisoning (3,10,20,21). In a few clinical studies, it was reported that leukocytosis could be used as a prognostic parameter for predicting the severity of organophosphate poisoning (3,23,24). Our findings were in compliance with those reported in the literature; however, we failed to identify leukocytosis as an independent risk factor for predicting mechanical ventilation requirement using multivariate analysis.…”

Section: Mechanically Ventilatedmentioning

confidence: 99%

“…Organophosphate poisoning by unintentional or suicidal ingestion is associated with high morbidity and mortality, particularly in developing countries (1). In Turkey, the number of patients with suicidal and unintentional organophosphate poisoning increases in spring and summer months during which many farmers spray their agricultural fields with organophosphate compounds (2,3). Despite all efforts to improve the management of organophosphate-poisoned patients, organophosphate poisoning is still a major public health problem across the world.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Red Cell Distribution Width in Patients with Organophosphate Poisoning

Dündar¹,

Köylü²,

Ergin³

et al. 2015

JAEM

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Aim: The aim of this retrospective study was to investigate the prognostic value of red cell distribution width (RDW) and other hematological parameters measured on admission to the emergency department in patients with organophosphate poisoning. Materials and Methods:All patients aged ≥15 years who were admitted to the emergency department from 2008 to 2013 on account of organophosphate poisoning were included in the study. The written and electronic medical charts of the patients were reviewed. Hematological parameters were recorded. Mechanical ventilation requirement was used as the primary endpoint.Results: A total of 72 patients were included in the study for evaluation. Mechanically ventilated patients had significantly higher leukocyte counts and RDW levels than non-ventilated patients (p=0.004 and p<0.001, respectively). The area under the receiver-operating characteristic curve of RDW levels for predicting mechanical ventilation requirement was 0.716 (95% CI: 0.581-0.852, p=0.010). RDW had a sensitivity of 73%, specificity of 70%, and negative predictive value of 91% with a cut-off value of 14.5% in predicting mechanical ventilation requirement in patients with organophosphate poisoning. Conclusion:RDW can be a valuable and easy-to-use parameter in estimating prognosis in the follow-up of patients with organophosphate poisoning. (JAEM 2015; 14: 65-9)

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Acute Organophosphate Poisoning in University Hospital Emergency Room Patients

Cited by 98 publications

References 25 publications

Preclinical study comparing the antidotal effect of clonidine with atropine for the treatment of acute malathion poisoning in the albino rats

Preclinical study comparing the antidotal effect of clonidine with atropine for the treatment of acute malathion poisoning in the albino rats

Organophosphate Poisoning Due to a Wheat Bagel

Prognostic Value of Red Cell Distribution Width in Patients with Organophosphate Poisoning

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