Acute organophosphorus insecticide poisoning

Abstract

Poisoning due to organophosphate insecticides is not infrequently fatal, as these highly toxic compounds produce irreversible inactivation of the cholinesterases. These compounds, developed during the last war, as potential chemical warfare agents, are extensively used for the extermination of insect pests. The purpose of this paper is to report a case of acute parathion poisoning and a second asymptomatic case of poisoning due to Fitios B/77, both treated successfully with atropine alone. In the treatment of organo-phosphorus poisoning, the administration of atropine sulphate in full dosage, by blocking the peripheral muscarine effects and by protecting against the involvement of the central nervous system, is still the mainstay of therapy. However, since atropine exerts no protective action against skeletal muscle paralysis, as soon as signs of respiratory paralysis are evident, mechanical ventilation combined with tracheostomy, should be set-up.