ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Clinical Approach To Organic Phosphor Intoxications: Review
Dr. Canan KUŞ SAYDAM,a Dr. Bülent SÖZMEN,a Dr. S. Leyla ASLANa
a3. İç Hastalıkları Kliniği, İzmir Atatürk Eğitim Hastanesi, İZMİR
Due to the widespread use of insecticides, organophosphate intoxications are encountered more often recently. These intoxications may manifest as respiratory depression that must be treated immediately. Organophosphate insecticides are neurotoxic agents that inhibit acetylcholine esterase (ACh E) activity in neuromusculer junctions and secretory glands. Thus, the clinical picture develops due to the hyperstimulation of parasympathetic peripheral and sympathetic cholinergic and rarely sympathetic adrenergic systems. Organophosphate toxication often causes malaise, blurring vision, hypersalivation, lacrimation, miosis, bradycardia, and hyperactivity of gastrointestinal smooth muscle. For a definitive diagnosis, reduction of ACh E activity must be shown. To classify patients as mild, moderate and severe according to clinical findings may be of value to predict the prognosis and to calculate the doses of atropine. On the other hand, usually there is a weak correlation between the clinical picture and the severity of toxication. The clinical picture and the percent of serum ACh E reduction together may give some additional guidance in therapy. Serum paraoxanase (PON) activity is another factor affecting the clinical situation. This enzyme is present in HDL particles and under normal conditions, it is responsible for the transformation of oxidized LDL to LDL. At the same time, it may hydrolize organic phosphor insecticides. According to genotype, PON activity may render the patient more resistant to toxication. Rarely some neurologic findings following the acute period may appear. Clinicians must be careful and expect delayed neurologic syndromes. The aim of this report was to review organic phosphor intoxications, which are frequently encountered in emergency clinics.Keywords: Phosphoric acid esters, poisoningTurkiye Klinikleri J Med Sci 2006, 26:73-77
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