Organochloride Poisoning Edited ppt.pptx

Op poisoning subtype

1. Organochloride Poisoning Dr. Satya Kiran

2. Organochlorines Organochlorine insecticides are chlorinated hydrocarbons and are divided into four types as: DDT ( dichlorodiphenyl -trichloroethane) and analogues Benzene hexachloride group — e.g. BHC, lindane Cyclodines and related compounds — e.g. endrin, aldrin, dieldrin, endosulfan , sobenzan Toxaphene and related compounds — e.g. toxaphene.

3. Availability These compounds are available as Dusting powder Emulsion Granules Solutions Fatal dose DDT 15 to 30 gm Lindane 15-30 gm Aldrin, endrin, dieldrin 2 to 6 gm

4. Absorption, Metabolism and Excretion Organochloride compounds are absorbed through skin, inhalation and through gastrointestinal tract. Most of the compounds are metabolized slowly in the body and remains in tissues, especially in fatty tissues for prolonged duration. These compounds are metabolized in liver and are excreted in urine, feces and milk.

5. Organochlorines affect nerve impulse transmission by altering membrane Na+ and K + flux, resulting in CNS hyperexcitability. Organochlorines produces myocardial irritability thus predisposing to cardiac arrhythmias DDT and related compounds affect the sodium channel and sodium conductance across the neuronal membrane, especially of axons Cyclodine and lindane appear to inhibit the GABAmediated chloride channels in the CNS. Mechanism of Action

6. Acute poisoning GIT - nausea, vomiting, diarrhea hyperaesthesia or paresthesia of mouth and face CNS - headache, vertigo, myoclonus, mydriasis, weakness, agitation, confusion, convulsions, coma. Respiratory system - cough, wheezing, if aspiration or inhalation occurs Renal failure Hepatitis Dermatitis Clinical Features

7. Acute poisoning GIT - nausea, vomiting, diarrhea hyperaesthesia or paresthesia of mouth and face CNS - headache, vertigo, myoclonus, mydriasis, weakness, agitation, confusion, convulsions, coma. Respiratory system - cough, wheezing, if aspiration or inhalation occurs Renal failure Hepatitis Dermatitis

8. Chronic Poisoning Exposure of these compounds for prolonged duration may result in cumulative toxicity characterized by Anorexia, Weight loss, Weakness, Tremors

9. Opsoclonus, Ataxia, Pseudotumor cerebri Abnormal mental changes, Oligospermia, Thrombocytopenic purpura. Lindane and BHC have been linked to aplastic anemia .

10. Skin - the affected part should be washed thoroughly with copious water Ocular - copious eye irrigation with normal saline or tap water Ingestion - gastric lavage and administration of activated charcoal Oxygen administration, ventilator assistance Maintain vital parameters, hydration, urine output Management

11. Convulsions should be controlled with judicious use of diazepam or lorazepam. Hyperthermia should be managed in usual way Arrhythmias can be managed with lidocaine. Avoid Giving Epinephrine - may exacerbate ventricular arrhythmias Management

12. Atropine Oil based fluid/food/cathartics Autopsy Findings Insecticide like smell Froth at mouth and nostrils Cyanosis Congestion of organs Pulmonary edema Cerebral edema .

13. Accidental poisoning may occur in farmers while spraying in the fields or opening the lid of the containers. Suicidal poisoning is also common with this insecticide. Homicidal is rare as it is difficult to mask the smell of insecticide. Management

14. Thank You