ORGANOPHOSPHOROUS

POISONING
Compounds
Alkyl phosphates-
Hexaethyl tetraphosphate(HETP)

Tetraethyl pyrophosphate(TEPP)

OCTAMETHYL PYROPHOSPHORAMIDE(OMPA)

Melathion
Aryl phosphates

Parathion
Diazinon
Cholinesterase
An enzyme in the brain which breaks apart the
neurotransmitter acetylcholine which is vital for
the transmission of nerve impulses.
Mode of action
Inhibitors of cholinesterase at the
myoneural junction and synapses of the
ganglions

Acetylcholine accumulates resulting in

hyperexcitation of voluntary and involuntary
muscles
Signs and symptoms
 Muscarinic effects

 Nicotinic effects

 CNS effects
MUSCARINIC
BRONCHIAL TREE-
Bronchospasm and increased secretions
GIT- anorexia, nausea, vomiting, heartburn,
diarrhea
SWEAT GLANDS- increased secretions
SALIVARY GLANDS- increased secretions
LACRIMAL GLANDS- increased secretions
HEART- Slight bradycardia
PUPILS- miosis

CILIARY BODY- BLURRING VISION

URINARY BLADDER-increased micturition

NICOTINIC
Striated muscles- muscle weakness,
fasciculations, fatigue

Sympathetic ganglia- pallor, elevated blood

pressure
CNS
Irritability, restlessness, tremors of hand,
eyelids, face and tongue, mental confusion
leading to coma due to respiratory and
circulatory depression.
FATAL DOSE-
HETP- 160mg i/v or i/m
350mg orally
OMPA-80mg i/v or i/m
175mg orally
TEPP- 45-50mg i/v or i/m
100mg orally
Melathion- 1gm orally
Parathion – 80mg i/v or i/m
Diazinon-1gm orally
Fatal period-
In Half to three hours
Treatment

DECONTAMINATION-
Remove from source
Stomach wash with water
Washing the area with tap water
CARE OF AIRWAY
ASPIRATE SECRETIONS

TRACHEOSTOMY

ARTIFICIAL RESPIRATION
ANTIDOTE
Atropine-
Blocks action of acetylcholine
2mg every 15-30 minutes i/m or
i/v till signs of atropinization
appear(flushed face, dry mouth,
dilated pupils, fast pulse, warm
skin)
Cholinesterase
reactivators-
Pralidoxine chloride and iodide

1-2 gms i/v or i/m in adults

25-50 mg/kg in children
POSTMORTEM APPEARANCE
Signs of asphyxia
Externally-
Blood stained froth from mouth and nostrils
Kerosine like smell from the body
Internally –
Greenish oily stomach contents
Kerosine or garlic odour
 Organophosphorous compound resist
putrefaction
Can be detected in putrefied bodies
and exhumed bodies
Medicolegal aspects
Pesticides
Vermicides
Rodenticides
Used as suicidal agents, homicidal after mixing
with alcohol, accidental in workers engaged in
manufacturing, packing or spraying.