Organophosphate (OP)

poisoning
 Introduction

 Organophosphate poisoning can occur

accidentally through occupational exposure,
ingestion of contaminated food or water, or
deliberately in cases of chemical warfare or
suicide attempts. Prompt recognition and
treatment are crucial for minimizing the effects
and improving outcomes in cases of OP
poisoning.
 Definition
 Organophosphate (OP) poisoning refers to
toxicity caused by exposure to
organophosphate compounds, which are a type
of chemical commonly found in pesticides,
insecticides, and nerve agents. These chemicals
inhibit the activity of acetylcholinesterase, an
enzyme responsible for breaking down
acetylcholine, a neurotransmitter in the
nervous system.
 Etiology

 The etiology of organophosphate (OP)

poisoning involves understanding how
exposure to these chemicals leads to toxicity in
the human body.
 Chemical Structure and Function:
Organophosphates are a class of chemicals that
include pesticides (like malathion and
chlorpyrifos), nerve agents (such as sarin and
VX), and industrial chemicals (like parathion).
They are characterized by a phosphorus atom
covalently bound to organic groups.
 Inhibition of Acetylcholinesterase: The
primary mechanism of toxicity in OP
poisoning is the inhibition of
acetylcholinesterase (AChE), an enzyme
responsible for breaking down acetylcholine
(ACh), a neurotransmitter involved in nerve
signal transmission.
 Accumulation of Acetylcholine: When OP
compounds inhibit AChE, acetylcholine
accumulates at nerve synapses and
neuromuscular junctions. This overstimulation
of cholinergic receptors leads to the
characteristic symptoms of OP poisoning,
including excessive salivation, sweating,
tearing, gastrointestinal disturbances, muscle
weakness, and respiratory failure.
 Route of Exposure
OP poisoning can occur through various routes:
 Dermal: Absorption through the skin,

particularly when handling pesticides without

adequate protective gear.
 Inhalation: Breathing in airborne OP particles

or vapors, common in industrial settings or

during chemical warfare.
 Ingestion: Swallowing pesticides or

contaminated food or water.

 Factors Influencing Toxicity
The severity of OP poisoning depends on several factors:
 Type of OP Compound: Some OP compounds are

more toxic than others due to their potency and ability

to inhibit AChE.
 Dose and Duration of Exposure: Higher doses or

prolonged exposure increase the risk and severity of

poisoning.
 Individual Sensitivity: Some individuals may be more

sensitive to OP compounds due to genetic factors or

health conditions.
 Clinical Manifestations
 Symptoms of OP poisoning can vary widely
but typically include a combination of
cholinergic effects (muscarinic, nicotinic, and
central nervous system effects) and can
progress to severe respiratory distress and
cardiovascular collapse in severe cases.
 Summary
 Sources of Exposure: Organophosphates are
widely used in agriculture (as pesticides),
industries (as solvents and intermediates), and in
chemical warfare (as nerve agents like sarin and
VX).
 Mechanism of Action: They work by irreversibly
inhibiting acetylcholinesterase, leading to an
accumulation of acetylcholine in nerve synapses
and neuromuscular junctions. This disrupts normal
nerve function.
 Symptoms: Symptoms of OP poisoning can vary widely
depending on the level of exposure and can include
excessive sweating, salivation, lacrimation (tear
production), blurred vision, headache, nausea, vomiting,
diarrhea, abdominal cramps, muscle weakness, tremors,
convulsions, and respiratory failure.
 Treatment: Immediate medical treatment is essential
and typically involves decontamination, administration
of antidotes such as atropine (which blocks the effects of
acetylcholine), and sometimes pralidoxime (which
reactivates acetylcholinesterase).
 Prognosis: The outcome of OP poisoning depends
on the severity of exposure and the promptness
and effectiveness of medical treatment. Severe
cases can be fatal due to respiratory failure or
cardiac arrest.
 Prevention: Prevention involves strict adherence
to safety protocols when handling
organophosphate-containing chemicals, including
wearing protective equipment and ensuring proper
ventilation.
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