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Anticholinesterase Agents: Poisoning and Treatment

Anticholinesterase Agents: Poisoning and Treatment

Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...

Prevention of Further Absorption of Poison

Prevention of Further Absorption of Poison

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...

Toxic Reactions: Overview

Toxic Reactions: Overview

When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...

Types of Toxins

Types of Toxins

Humans continually engage with an environment rich in potentially harmful chemicals. These are introduced to our bodies through inhalation, ingestion, or skin contact. These chemicals exist in various forms, such as air and environmental pollutants, agricultural chemicals, organic solvents, and heavy metals.
Air pollutants, primarily gases, pose significant threats to respiratory health, leading to conditions like hypoxia, lung cancer, and in extreme cases, death.
Environmental pollutants like...

Enhanced Elimination of Poison

Enhanced Elimination of Poison

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...

Antidotes

Antidotes

Antidotes are medicinal substances used to counteract the harmful effects of toxins or drugs in the body. They function in various ways, each uniquely designed to combat specific toxic compounds.
Specific antidotes operate by inhibiting the enzymes that control biochemical pathways, reducing the production of harmful metabolites.
An example of an antidote is atropine, which counteracts the detrimental effects of cholinesterase inhibitors. It achieves this by deactivating muscarinic receptors,...

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Paraquat: The Poison Potion.

Cynthia A Sukumar¹, Vishal Shanbhag², Ananthakrishna B Shastry¹

¹Department of General Medicine, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine

|February 6, 2020

Summary

Paraquat poisoning is highly fatal, with limited evidence for current treatments. Early hemoperfusion and Edaravone show promise for managing paraquat toxicity and organ damage.

Keywords:

Clinical toxicology Edavarone Paraquat Pesticide poisoning Poisoning Pulmonary fibrosis

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Area of Science:

Toxicology
Emergency Medicine
Pharmacology

Background:

Paraquat is a widely used herbicide in India with high toxicity and mortality.
Limited evidence-based recommendations exist for managing paraquat poisoning.
High case fatality rates underscore the need for effective treatment strategies.

Purpose of the Study:

To review the diagnosis and management of paraquat poisoning.
To highlight recent advances in treatment for paraquat toxicity.
To identify gaps in evidence for current and novel therapeutic interventions.

Main Methods:

Review of existing literature on paraquat poisoning diagnosis and management.
Analysis of studies on conventional treatments like immunosuppressants and antioxidants.
Evaluation of emerging therapies including hemoperfusion and Edaravone.

Main Results:

Conventional treatments (immunosuppressants, antioxidants) lack proven survival benefits.
Early hemoperfusion (within 4 hours) may be beneficial.
Edaravone shows potential in preventing renal and hepatic injury and delaying pulmonary fibrosis, but does not prevent it.

Conclusions:

There is a critical need for more clinical and experimental studies to validate treatment efficacy.
Early intervention with hemoperfusion and the use of Edaravone warrant further investigation.
Addressing the high mortality of paraquat poisoning requires robust evidence-based treatment guidelines.