Title: A Prospective Observational Study of Acid Base Disorders in Organophosphorous Poisoning in a Tertiary Care Centre

Authors: Dr Vemu Meghana, Dr B. Ashok Babu, Dr K.Sudheer

 DOI: https://dx.doi.org/10.18535/jmscr/v11i3.11

Abstract

Introduction

Pesticides include a wide variety of compounds which include insecticides, herbicides, fungicides, and others. There are more than 1000 active substances determined in approximately 35,000 preparations of pesticides used in agriculture. Organo phosphorus (OP) pesticide poisoning is a serious hazard .Farmers are at high risk for accidental exposure to OPC poisoning as it can be absorbed from ingestion (mc route),inhalation or tropical contact. However, poisoning with suicidal intent is more common than accidental exposure. Intentional ingestion of OP pesticides has been common for the past 40 years. A fatal outcome is often related to delay in diagnosis or improper management .OPCs are available as dust, granules, or liquids. OPCs are very well absorbed from the lungs, gastrointestinal tract, skin, mucous membranes, and conjunctiva following inhalation, ingestion, or topical contact. Most OPCs are lipophilic. Peak levels of most OP insecticides measure around 6 h after oral ingestion in man. Exposure to OP vapors rapidly causes upper airway irritation and bronchospasm followed by systemic symptoms. Acute respiratory failure is the most common cause of death in OPC poisoning due to increased secretions and inadequate ventilation. One of the cause for complications is an acid base imbalance. Subsequent measures must be carried out by recognizing and correcting the acid-base disturbance at the earliest possible time. Evaluation of acid-base status in the OPC poisoning patients plays a critical role as its early recognition can alter the management and prognosis.

References

  1. World Health Organization. Organophosphorus Insecticides a General Effects of Organophosphorus Insecticides on the Nervous System. Geneva: World Health Organization; 1986.
  2. Balali-Mood M, Shahab-Ahmadi A, Salimifar M, Shariate M, editors. Effects of Sodium Bicarbonate in Organophosphate Pesticide Poisoning. Spiez, Switzerland: 3rd Proceedings of Chemical and Biological Medical Treatment Symposium, CBMTS III; 2000.
  3. S Subikshavarthni1, R Selvan2 1 Consultant, Department of Emergency Medicine, Meenakshi Memorial Hospital, Rajapalayam, Tamil Nadu, India, 2 Professor, Department of Neurosurgery, Kanyakumari Government Medical College, Kanyakumari, Tamil Nadu, India
  4. World Health Organization. Organophosphorus Insecticides a General Introduction. Metabolism and Mode of Action. Geneva: World Health Organization; 1986. p. 39-48.

Corresponding Author

Dr Vemu Meghana

Postgraduate, Department of General Medicine, GEMS