ORGANOFOSFAT İNTOKSİKASYONU: TERAPÖTİK AFEREZ UYGULAMASI

Yıl 2022, Cilt: 8 Sayı: 1, 67 - 70, 01.02.2022

Nurdan Unlu

Öz

ÖZET

Organofosfat intoksikasyonunda mortalite genellikle gecikmiş ya da uygun olmayan tedavinin sonucudur. Destek tedavi yanında atropin ve pralidoksim farmakolojik ajan olarak kullanılmaktadır. Bu yazıda, uygulanan klasik tedavilere yanıt vermeyen fakat terapötik plazma değişimi ile dramatik olarak klinik tablosu düzelen ciddi organofosfat intoksikasyonu olan olgu sunulmaktadır.

Anahtar Kelimeler: Organofosfat, Terapötik Plazma Değişimi, Pralidoksim

ABSTRACT

Mortality in organophosphate intoxication is usually the result of delayed or inappropriate treatment. In addition to supportive treatment, atropine and pralidoxime are used as pharmacological agents. In this article, a case with severe organophosphate intoxication, which did not respond to conventional treatments, but whose clinical picture improved dramatically with therapeutic plasma exchange is presented.

Key Words: Organophosphate, Therapeutic Plasma Exchange, Pralidoxime

Anahtar Kelimeler

organofosfat, terapötik plazma değişimi, pralidoksim, organophosphate, therapeutic plasma exchange, pralidoxime

Kaynakça

• Sungur, M. & Guven, M. (2001) Intensive care management of organophosphate insecticide poisoning. Crit Care, 5:211-5.
• Sivagnanam, S. (2002) Potential therapeutic agents in the management of organophosphorus poisoning. Crit Care, 6:260-1.
• Kwong, T.C. (2002) Organophosphate pesticides: Biochemistry and clinical toxicology. Ther Drug Monit, 24:144-9.
• Robey WC & Meggs WJ. (2004) Insecticides, Herbicides and Rodenticides. In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine: a Comprehensive Study Guide. 6th Ed. McGraw-HillCo, New York, pp. 1134–43.
• Disel, N. R., Acikalin, A., Kekec, Z. & Sebe, A. (2016) Utilization of plasmapheresis for organophosphate intoxication: A case report. Turk J Emerg Med, 7;16(2):69-71.
• Yesilbas, O., Kihtir, H. S., Altiti, M., Petmezci, M. T., Balkaya, S., Duramaz, B. B., ..., & Sevketoglu, E. (2015) Acute Severe Organophosphate Poisoning in a Child Who was Successfully Treated With Therapeutic Plasma Exchange, High-Volume Hemodiafiltration, and Lipid Infusion. J Clin Apher, 31(5):467-9.
• Yilmaz, M., Sebe, A., Ay, M.O., Gumusay, U., Topal, M., Atli, M., ..., & Satar, S. (2013) Effectiveness of therapeutic plasma exchange in patients with intermediate syndrome due to organophosphate intoxication. Am J Emerg Med, 31:953–957.
• Guven, M., Sungur, M. & Eser, B. (2004) The effect of plasmapheresis on plasmacholinesterase in a patient with organophosphate poisoning. Hum Exp Toxicol, 23:365–8.
• Qiu, H.M., Zheng, S.C., Wan, W.G. & Zou, H.J. (2013) Meta-analysis of the effectiveness of plasma exchange in treatment of severe and acute organophosphate poisoning. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi, 29:779–781.