CHETTY FMT.pptx,............. ...... .

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1. ORGANOPHOSPHORUS COMPOUNDS 13-Aug-24 1 CHETTY

2. INTRODUCTION 13-Aug-24 2 CHETTY

3. CLASSIFICATION 13-Aug-24 3 CHETTY

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9. 13-Aug-24 9 CHETTY

10. Other Neurological Manifestations : Type 1 Paralysis: Acute paralysis within 24-48 Hours. Due to persistent depolarization at NMJ due to blockade od AChE . Fasiculations , Cramps, Weakness, Paralysis of Respiratory muscles. Respiratory failure. Rx: Atropine. Type 2 Paralysis : 2-4 days after resolution of acute cholinergic symptoms. Manifests as Paralysis & Respiratory distress. Due to Neuromuscular transmission defect or toxin induced muscle instability or inadequate treatment. Weakness of Proximal Limb muscles, Neck Flexor, Resp Muscles & Cranial nerve palsy. Delayed deaths +/- Do not respond to Atropine / Oximes . Type 3 Paralysis : 1-4 weeks after exposure to OP Compounds. Paralysis of lower extremities, foot drop & numbness. Gradually progress upwards. Parasthesia +/-. Sensory symptoms subside in 1-2 months, but paralysis persists. Do not respond to Atropine / Oximes . 13-Aug-24 GUNA 10

11. Treatment: In GENERAL , clothes of the patient to be removed, body to be washed with soap & water to prevent cutaneous absorption of OPC. Irrigation of eyes , if contaminated. Maintain patent airway . Oxygen therapy if cyanosis +. Stomach wash with 1:1000 KMnO4 Soln. if the poison was ingested; with or without activated charcoal. Atropine Sulphate reverses effect of Ach. Acts as a physiological antidote Reverses the Muscarinic Effects of ACh at the Muscarinic receptors. So there is decreased Parasympathetic activity. No effect on Nicotinic symptoms as it do not act on those receptors. So, no action a NMJ. DOSE : 2-4 mg every 10-15 mintues till signs of atropinization appears Dilatation of pupil and decrease of secretions. 13-Aug-24 GURU 11

12. 13-Aug-24 12 Treat with Oximes , as specific antidotes . React with phosphate moiety of OP- AChE complex and get phosphorylated. AChE is released from the complex and thus reactivated. Decreases the Muscarinic, nicotininc and CNS effects within 10-40 minutes. Oximes to be administered as early as possible, before the complex becomes irreversible. Not beneficial if given after 48 hours of poisoning. By this time, the complex will become irreversible. GURU