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Management of Organophosphorus Poisoning: Standard Treatment and Beyond
Sakib Aman1, Shrebash Paul2, Fazle Rabbi Chowdhury2
1Department of Medicine, Dhaka Medical College Hospital, Secretariat Road, Dhaka 1000, Bangladesh.
Abstract:
Organophosphorus (OP) compounds remain a leading cause of self-poisoning and mortality, especially in South East Asia, China, and Africa. Organophosphorus causes an acute cholinergic syndrome by inhibiting acetylcholinesterase. Atropine remains the mainstay of treatment, but recently some promising therapies are in the pipeline. Oximes are used widely in the management of organophosphorus poisoning, however clinical efficacy remains to be established. Magnesium sulfate, calcium channel blockers (nimodipine), plasma alkalinizing agents, β-2 agonists, nicotinic receptor antagonists, clonidine, and lipid emulsions are promising treatment alternatives. However, large phase III trials are required to establish their efficacy.
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