Organophosphate Poisoning and Intermediate Syndrome

Mustafa Yılmaz; Ahmet Sebe; Mehmet Ay; Mehtap Gürger

doi:10.17827/aktd.75984

EN TR

Organophosphate Poisoning and Intermediate Syndrome

Öz

Toxic effects that occur after acute organophosphate poisoning (OP) can manifest three phases, namely, acute cholinergic crisis, intermediate syndrome and delayed-type polyneuropathy. Clinical signs and symptoms of organophosphate poisoning depend on the accumulation of acetylcholine at the nerve junction. Organophosphate poisoning causes three main clinical findings; acute cholinergic crisis consisting of muscarinic, nicotinic and central nervous system symptoms, intermediate syndrome with recurrence of cholinergic symptoms or muscle weakness without fasciculation 24-96 hours after poisoning and delayed-type polyneuropathy that can usually occur several days or weeks after acute exposure to organic phosphorus compounds. In this article, intermediate syndrome, which is a late complication, has been reviewed.

Anahtar Kelimeler

-

Kaynakça

Sivagnanam S. Potential therapeutic agents in the management of organophosphorus poisoning. Crit Care. 2002;6:260-1.
Thiermann H, Szinicz L, Eyer F, Worek F, Eyer P, Felgenhauer N et al. Modern strategies in therapy of organophosphate poisoning. Toxicol Lett. 1999;107:233-9.
Kwong TC. Organophosphate pesticides: b iochemistry and clinical toxicology. Ther Drug Monit. 2002;24:144-9.
Johnson MK, Jacobsen D, Meredith TJ, Eyer P, Heath AJ, Lintenstein AD et al. Evaluation of antidotes for poisoning by organophosphorus pesticides. Emerg Med. 2000;12:22-37.
Storm JE, Rozman KK, Doull J. Occupational exposure limits for 30 organophosphate pesticides based on inhibition of red blood cell acetylcholinesterase. Toxicology. 2000;150:1-29.
Guven M, Ünlühızarcı K, Göktaş Z, Kurtoglu S. Intravenous organophosphate injection: an unusual way of intoxication. Hum Exp Toxicol. 1997;16:279-80.
Karalliedde L, Senanayake N. Organophosphorus insecticide poisoning. Br J Anaesth. 1989;63:736-750.
Pope CN. Organophosphorus pesticides: do they all have the same mechanism of toxicity? J Toxicol Environ Health B Crit Rev. 1999;2:161-81.
Bardin PG, Van Eeden SF, Moolman JA, Foden AP, Joubert JR. Organophosphate and carbamate poisoning. Arch Intern Med. 1994;154:1433-41.
Senanayake N, Karalliedde L. Neurotoxic effects of organophosphorus insecticides: an intermediate syndrome. New Engl J Med. 1987;316:761-3.

Eyer P. Neuropsychopathological changes by organophosphorus compounds: a review. Hum Exp Toxicol. 1995;14:857–64.
De Bleecker J, Van Den Neucker K, Willems J. The intermediate syndrome in organophosphate poisoning: presentation of a case and review of the literature. J Toxicol-Clin Toxicol. 1992;30:321–9.
Lotti M, Moretto A. Organophosphate-induced delayed polyneuropathy. Toxicol Rev. 2005;24:37–49.
Namba T, Nolte CT, Jackrel J, Grob D. Poisoning due to organophosphate insecticides. Acute and chronic manifestations. Am J Med. 1971;50:475-92.
Emerson GM, Gray NM, Jelinek GA, Mountain D, Mead HJ. Organophosphate poisoning in Perth, Western Australia, 1987-1996. J Emerg Med. 1999;17:273-77.
Karalliedde L. Organophosphorus poisoning and anaesthesia. Anaesthesia. 1999;54:1073-88.
Khan S, Hemalatha R, Jeyaseelan L, Oommen A, Zachariah A. Neuroparalysis and oxime efficacy in organophosphate poisoning: a study of butyrylcholinesterase. Hum Exp Toxicol. 2001;20:169-74.
John M, Oommen A, Zachariah A. Muscle injury in organophosphorus poisoning and its role in the development of intermediate syndrome. Neurotoxicol. 2003;24:43-53.
Dandapani M, Zachariah A, Kavitha MR, Jeyaseelan L, Oommen A. Oxidative damage in intermediate syndrome of acute organophosphorus poisoning. Ind J Med Res. 2003;117:253–9.
De Bleecker JL. The intermediate syndrome in organophosphate poisoning: An overview of experimental and clinical observations. J Toxicol Clin Toxicol. 1995;33:683-6.
Baker DJ, Sedgwick EM. Single fiber electromyographic changes in man after organophosphate exposure. Hum Exp Toxicol. 1996;15:369–75.
Sedgwick EM, Senanayake N. Pathophysiology of the intermediate syndrome of organophosphorus poisoning. J Neurol Neurosurg Psychiatr. 1997;62:201–2.
He F, Xu H, Qin F, Xu L, Huang J, He X. Intermediate myasthenia syndrome following acute organophosphates poisoning: an analysis of 21 cases. Hum Exp Toxicol. 1998;17:40–5.
Parker PE, Brown FW. Organophosphate intoxication: Hidden hazards. South Med J. 1989;82:1408-10.
Routier RJ, Lipman J, Brown K. Difficulty in weaning from respiratory support in a patient with the intermediate syndrome of organophosphate poisoning. Crit Care Med. 1989;17:1075-6.
Sudakin DL, Mullins ME, Horowitz BZ, Abshier V, Letzig L. Intermediate syndrome after malathion ingestion despite continuous infusion of pralidoxime. J Toxicol Clin Toxicol. 2000;38:47-50.
DeBleeker JL. Multiple system organ failure: Link to intermediate syndrome indirect. J Toxicol Clin Toxicol. 1996;34:249-50.
DeBleeker JL, Van Den Neucker K, Colardyn F. Intermediate syndrome in organophosphorus poisoning: A prospective study. Crit Care Med. 1993;21:1706.
De Bleecker J, Vogelaers D, Ceuterick C, Van Den Neucker K, Willems J, De Reuck J. Intermediate syndrome due to prolonged parathion poisoning. Acta Neurol Scand. 1992;86:421-4.
DeBleecker JL, Willems J, Van Den Neucker K, De Reuck J, Vogelaers D. Prolonged toxicity with intermediate syndrome after combined parathion and methyl parathion poisoning. J Toxicol Clin Toxicol. 1992;30:333-45.
Gadoth N, Fisher A. Late onset of neuromuscular block in organophosphorus poisoning. Ann Intern Med. 1978;88:654-5.
Senanayake N, Sanmuganathan PS. Extrapyramidal manifestations complicating an organophosphorus poisoning. Hum Exp Toxicol. 1995;14:600-4.
DeBleecker JL. Intermediate syndrome: Prolonged cholinesterase inhibition. J Toxicol Clin Toxicol. 1993;31:197-9.
John M, Oommen A, Zachariah A. Muscle injury in organophosphorous poisoning and its role in the development of intermediate syndrome. Neurotoxicology. 2003;24:43-53.
Yang D, Lu X, Zhang W, He F. Biochemical changes in primary culture of skeletal muscle cells following dimethoate exposure. Toxicology. 2002;174:79-85.
Chen JG. The therapeutic effects of obidoxime chloride on intermediate syndrome following acute organophosphate poisoning. Chin J Curr Tradit West Med. 2004;2:945–6.
Benson BJ, McIntire M. Is the intermediate syndrome in organophosphate poisoning the result of insufficient oxime therapy? J Toxicol-Clin Toxicol. 1992;30:347–9.
Bowls BJ, Freeman Jr JM, Luna JA, Meggs WJ. Oral treatment of organophosphate poisoning in mice. Acad Emerg Med. 2003;10:286-8.
Peköz T, Yüzügüllü M, Kekeç Z, Koç F. Akut organofosfat zehirlenmelerinde nöromusküler etkilenim. Cukurova Medical Journal. 2014;39:795-800.
Öztürk MA, Kelestimur F, Kurtoglu S, Güven K, Arslan D. Anticholinesterase poisonings in Turkey- clinical, laboratory and radiologic evaluation of 269 cases. Hum Exp Toxicol. 1990;9:273-9.
Coye M J, Barnet P G, Midtling J E, Velasco AR, Romero P, Clements CL et al. Clinical confirmation of organophosphate poisoning by serial cholinesterase analysis. Arch intern Med. 1987;147:438- 42.
Coye M J, Lowe J A, Maddy K T. Biological monitoring of agricultural workers exposed to pesticides. I. Cholinesterase activity determinations. J Occup Med. 1986;28:619-27
Besser R, Weileman LS, Gutmann L. Efficacy of obidoxime in human organophosphorus poisoning: Determination by neuromuscular transmission studies. Muscle Nerve. 1995;18:15-22.
Aygun D, Doganay Z, Altintop L, Guven H, Onar M, Deniz T, et al. Serum acetylcholinesterase and prognosis of acute organophosphate poisoning. J Toxicol Clin Toxicol. 2002;40:903-10.
Fuortes LJ, Ayebo AD, Kross BC. Cholinesterase-inhibiting insecticide toxicity. Am Fam Physician. 1993;47:1613-20.
Kayaalp O. Tıbbi Farmakoloji, 5. Baskı, Ankara, Hacettepe TAŞ, 1989.
Longo VG. Behavioral and electroencephalographic effects of atropine and related compounds. Pharmacol Rev. 1966;18:965-96.
Kaplovitz I, Mento R, Matthews C, Shutz M, Nails C, Kelly S. Dose–response effects of atropine and H1-6 treatment of organophosphorus poisoning in guinea pigs. Drug Chem Toxicol. 1995;18:119- 36.
Dikart W L, Kiestra S H, Sangster B. The use of atropine and oximes in organophosphate intoxication: J Toxicol Clin Toxicol.1988;26:199-208.
Eddleston M, Dawson A, Karalliedde L, Dissanayake W, Hittarage A, Azher S, et al. Early management after self-poisoning with an organophosphorus or carbamate pesticide; A treatment protocol for junior doctors. Crit Care. 2004;8:391-7.
Sungur M, Guven M. Intensive care management of organophosphate insecticide poisoning. Crit Care. 2001;5:211-5.
Balali-Mood M, Shariat M. Treatment of organophosphate poisoning. experience of nerve agents and acute pesticide poisoning on the effects of oximes. J Physiol Paris. 1998;92:375-8.
Robenshtok E, Luria S, Tashma Z, Hourvitz A. Adverse reaction to atropine and the treatment of organophosphate intoxication. Isr Med Assoc J. 2002;4:535-9.
Uehara S, Hiromori T, Suzuki T, Kato T, Miyamoto J. Studies on the therapeutic effect of 2-pyridine aldoxime methiodide (2-PAM) in mammals following organophosphorous compound (op)- poisoning (report II): Aging of op-inhibited mammalian cholinesterase. J Toxicol. 1993;18:179- 83.
Masson P, Froment MT, Bartels CF, Lockridge O. Importance of aspartate-70 in organophosphate inhibition, oxime re-activation and aging of human butyrylcholinesterase. Biochem J. 1997;325:53-61.
Kassa J. Review of oximes in the antidotal treatment of poisoning by organophosphorus nerve agents. J Toxicol Clin Toxicol. 2002; 40:803-16.
Eddleston M, Szinicz L, Eyer P, Buckley N. Oximes in acute organophosphorus pesticide poisoning: A systematic review of clinical trials. Q J Med. 2002;95:275-83.
Rotenberg J, Newmark J. Nerve agent attacks on children: Diagnosis and management. Peds. 2003;112:648-58.
Schexnayder S, James L, Kearns G, Farrar H. The pharmacokinetics of continuous infusion pralidoxime in children with organophosphate poisoning. J Toxicol Clin Toxicol. 1998;36:549-55.
Tush G, Anstead M. Pralidoxime continuous infusion ion the treatment of organophosphate poisoning. Ann Pharmacother. 1997;31:441-4.
Willems JL, Langenberg JP, Verstraete AG, De Loose M, Vanhaesebroeck B, Goethals G, et al. Plasma concentrations of pralidoxime methyl sulfate in organophosphorus poisoned patients. Arch Toxicol. 1992;66:260-6.
Kiss Z, Fazekas T. Organophosphates and torsade de pointes ventricular tachycardia. J Roy Soc Med. 1983;76:983-4.
Petroianu G, Ruefer R. Beta-blockade or magnesium in organophosphorus insecticide poisoning. Anaesth Intensive Care. 1992;20:538-9.
Buccafusco JJ, Aronstam RS. Clonidine protection from the toxicity of soman, an organophosphate acetylcholinesterase inhibitor, in the mouse. J Pharmacol Exp Ther. 1986;239:43-7.
Clement JG, Filbert M. Antidote effect of sodium fluoride against organophosphate poisoning in mice. Life Sci. 1983;32:1803-10.
Guven M, Sungur M, Eser B, Sarı İ, Çoban Ö. The human plasma in the treatment of organophosphate poisonings. Intensive Care Med. 2003;29:112.
Yilmaz M, Sebe A, Ay MO, Gumusay U, Topal M, Atli M et al. Effectiveness of therapeutic plasma exchange in patients with intermediate syndrome due to organophosphate intoxication. Am J Emerg Med. 2013;31:953–7.
Correspondence Address / Yazışma Adresi Mustafa Yılmaz
Fırat Üniversitesi. Tıp Fakültesi
Acil Tıp Anabilim Dalı. Elazığ, Turkey
e-mail: drmylmz@hotmail.com
Geliş tarihi/ Received: 12.04.2015
Kabul tarihi/Accepted: 03.06.2015

Ayrıntılar

Birincil Dil

İngilizce

Konular

-

Bölüm

-

Yazarlar

Mustafa Yılmaz

Ahmet Sebe Bu kişi benim

Mehmet Ay Bu kişi benim

Mehtap Gürger Bu kişi benim

Yayımlanma Tarihi

31 Mart 2016

Gönderilme Tarihi

9 Aralık 2015

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2016 Cilt: 25 Sayı: 1

DOI

https://doi.org/10.17827/aktd.75984

IZ

https://izlik.org/JA68BJ52GW

APA

Yılmaz, M., Sebe, A., Ay, M., & Gürger, M. (2016). Organophosphate Poisoning and Intermediate Syndrome. Arşiv Kaynak Tarama Dergisi, 25(1), 70-83. https://doi.org/10.17827/aktd.75984

AMA

1.Yılmaz M, Sebe A, Ay M, Gürger M. Organophosphate Poisoning and Intermediate Syndrome. aktd. 2016;25(1):70-83. doi:10.17827/aktd.75984

Chicago

Yılmaz, Mustafa, Ahmet Sebe, Mehmet Ay, ve Mehtap Gürger. 2016. “Organophosphate Poisoning and Intermediate Syndrome”. Arşiv Kaynak Tarama Dergisi 25 (1): 70-83. https://doi.org/10.17827/aktd.75984.

EndNote

Yılmaz M, Sebe A, Ay M, Gürger M (01 Şubat 2016) Organophosphate Poisoning and Intermediate Syndrome. Arşiv Kaynak Tarama Dergisi 25 1 70–83.

IEEE

[1]M. Yılmaz, A. Sebe, M. Ay, ve M. Gürger, “Organophosphate Poisoning and Intermediate Syndrome”, aktd, c. 25, sy 1, ss. 70–83, Şub. 2016, doi: 10.17827/aktd.75984.

ISNAD

Yılmaz, Mustafa - Sebe, Ahmet - Ay, Mehmet - Gürger, Mehtap. “Organophosphate Poisoning and Intermediate Syndrome”. Arşiv Kaynak Tarama Dergisi 25/1 (01 Şubat 2016): 70-83. https://doi.org/10.17827/aktd.75984.

JAMA

1.Yılmaz M, Sebe A, Ay M, Gürger M. Organophosphate Poisoning and Intermediate Syndrome. aktd. 2016;25:70–83.

MLA

Yılmaz, Mustafa, vd. “Organophosphate Poisoning and Intermediate Syndrome”. Arşiv Kaynak Tarama Dergisi, c. 25, sy 1, Şubat 2016, ss. 70-83, doi:10.17827/aktd.75984.

Vancouver

1.Mustafa Yılmaz, Ahmet Sebe, Mehmet Ay, Mehtap Gürger. Organophosphate Poisoning and Intermediate Syndrome. aktd. 01 Şubat 2016;25(1):70-83. doi:10.17827/aktd.75984

Cited By

Heavy hemolysis after organophosphate poisoning by chlorpyrifos ethyl

Archives of Current Medical Research

https://doi.org/10.47482/acmr.1131153

Organophosphate Poisoning and Intermediate Syndrome

Organophosphate Poisoning and Intermediate Syndrome

Öz

Anahtar Kelimeler

Organofosfat Zehirlenmesi ve İntermediate Sendromu

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

Kaynak Göster

Cited By

Heavy hemolysis after organophosphate poisoning by chlorpyrifos ethyl