Repeated pulse intramuscular injection of pralidoxime chloride in severe acute organophosphorus pesticide poisoning.

Abstract

OBJECTIVE:

This study aimed to clarify the efficacy of 2 therapies for patients with severe acute organophosphorus pesticide poisoning, including atropine adverse effects, the length of intensive care unit (ICU) stay, complications, and mortality.

METHODS:

A retrospective cohort study of 152 cases collected from May 2008 to November 2012 at 2 urban university hospitals was conducted. Patients admitted to the hospital for organophosphate poisoning were divided into 2 groups with different therapeutic regimens: group A was administered a repeated pulse intramuscular injection of pralidoxime chloride, and group B received the same initial dosage of atropine and pralidoxime chloride, but pralidoxime chloride intravenous therapy was administered for only 3 days, regardless of the length of atropine therapy. Subsequently, atropine adverse effects, length of ICU stay, complications, and mortality were statistically analyzed and compared between the 2 groups.

RESULTS:

The total dose of atropine was 57.40 ± 15.14 mg in group A and 308.26 ± 139.16 mg in group B; group A received less atropine than did group B (P = .001). The length of ICU stay in group A was reduced (P = .025), and group A had fewer atropine adverse effects (P = .002). However, there was no significant difference in the mortality or complication rate between the 2 groups (P > .05).

CONCLUSION:

In patients with severe poisoning, group A used less atropine, had fewer atropine adverse effects, and had a shorter ICU stay. We suggest that therapy should be started as early as possible using a sufficient amount of pralidoxime chloride started intramuscularly in combination with atropine and that the drugs should not be prematurely discontinued.

• Authors: Xue Tang, Ruilan Wang, Hui Xie, Jiachang Hu, Wenbiao Zhao
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 31 Issue 6 Pg. 946-9 (Jun 2013) ISSN: 1532-8171 [Electronic] United States
• PMID: 23680326 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Antidotes
• Pralidoxime Compounds
• Atropine
• pralidoxime

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antidotes (administration & dosage, adverse effects, therapeutic use)
• Atropine (administration & dosage, adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Injections, Intramuscular
• Intensive Care Units (statistics & numerical data)
• Length of Stay
• Male
• Middle Aged
• Organophosphate Poisoning (drug therapy, mortality)
• Pralidoxime Compounds (administration & dosage, adverse effects, therapeutic use)
• Retrospective Studies
• Young Adult