Abstract |
Early treatment of organophosphate (OP) poisoning with oximes results in reactivation of acetylcholinesterase and patient recovery. Data on efficacy of late administration of oximes, particularly obidoxime, is limited. A 42-y old woman swallowed 60 ml of 50% malathion in a suicide attempt. Characteristic muscarinic, nicotinic and central manifestations of OP poisoning appeared: atropine and 250 mg obidoxime i.v., resulted in marked improvement. Several hours after the last dose, clinical manifestations recurred and ventilation was required. After 10 d cholinesterase was still low and liver enzymes were elevated. Obidoxime was reinstituted after the 9 d interruption and muscle strength improved with the first dose. The patient could be disconnected from the ventilator and within <24 h was extubated. Oxime therapy should be considered even late in the course of untreated or partially treated OP intoxications, especially when the etiologic agent is a lipid-soluble compound (ie malathion) that can cause a protracted course of poisoning. The clinical course of this patient did not support a cause-and-effect relationship between obidoxime and the abnormal liver function.
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Authors | Yedidia Bentur, Bianca Raikhlin-Eisenkraft, Pierre Singer |
Journal | Veterinary and human toxicology
(Vet Hum Toxicol)
Vol. 45
Issue 1
Pg. 33-5
(Feb 2003)
ISSN: 0145-6296 [Print] United States |
PMID | 12583695
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Cholinesterase Reactivators
- Insecticides
- Obidoxime Chloride
- Atropine
- Malathion
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Topics |
- Adult
- Atropine
(administration & dosage)
- Cholinesterase Reactivators
(administration & dosage)
- Diagnosis, Differential
- Emergency Treatment
- Female
- Humans
- Infusions, Intravenous
- Insecticides
(poisoning)
- Malathion
(poisoning)
- Obidoxime Chloride
(administration & dosage)
- Poisoning
(diagnosis, drug therapy)
- Respiration, Artificial
- Suicide, Attempted
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