A farmer with pinpoint pupils, increased secretions and urination. What is the most likely diagnosis?
Correct Answer: Organophosphate poisoning
Description: The above clinical findings are suggestive of OPC poisoning. Organophosphate poisoning (OPC poisoning) - OPC compounds - Parathion (follidol) Methyl parathion Malathion HETP, TEPP Diazinon (Tik 20) Smell - Kerosene like (due to presence of Aromax) MOA - Inhibits Acetylcholinesterase enzyme Clinical features - Muscarinic Nicotinic 'SLUDGE BBB' Monday - Mydriasis S - Salivation Tuesday - Tachycardia L - Lacrimation (Red tears) Wednesday - Weakness of muscles U - | Urination Thursday - Hypeension D - Diarrhoea Friday - Fasciculations G - GIT upset E - Emesis B - Bronchospasm B - Blurring of vision (Constricted pupil) B - Bradycardia Diagnosis - Check the Cholinesterase enzyme levels - True Cholinesterase (RBC) Pseudocholinesterase - Correlates with Clinical features - Sensitive 2. Para nitrophenol test - Done for Parathion poisoning Rx - Decontamination Atropine i.v (Blocks the muscarinic effects) Oximes (Acetylcholinesterase enzyme reactivator) - Pralidoxime Suppoive Rx
Category:
Physiology
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