Sodium Bicarbonate and N-Acetyl Cysteine in Treatment of Organophosphorus Poisoning Cases: A Randomized Controlled Clinical Trial

Abstract

Introduction: Organophosphorus poisoning (OPP) is an important health problem in many parts of the world particularly in developing countries. However, the treatment did not change since many years, despite the increasing complications and case fatalities of the exposure. From the clinical experience, some pharmacologic agents had proved useful in improving the outcome and decreasing the complications of this exposure.

Protective effect of acetylcysteine against thiamethoxam-induced hepatic and renal toxicity in rats

“…To mitigate the toxicity of certain OPs, NAC can be utilized as a preventive and therapeutic drug [24]. NAC, in combination with sodium bicarbonate [104] or atropine Shadnia [105] was also advised for treating humans to alleviate the negative effects of OPs, such as shortening hospital stays. In line with Abouelella, et al [106] who cited that, NAC reduces nicotine-induced oxidative stress and reproductive damage in male rats.…”

Ischemia-modified Albumin as a Marker of Coronary Ischemia in Acute Organophosphorus-poisoned Patients: a Case-Control Study in Mansoura University Poison Unit

“…Then, a proper history taking, a careful clinical examination, appropriate investigations, and a consideration of all possible intervening factors, can make the investigator to reach more accurate results. Jiao et al [15] believe that the IMA provides 77.4% sensitivity and 86.6% specificity for predicting cardiac ischemia, and that it is hence superior to electrocardiogram, cardiac troponin I, and creatine kinase-MB for the early diagnosis of myocardial ischemia [16]. No studies exist in literature regarding the value of IMA levels in OPP patients.…”