Pesticides

Question 1

What is MOT?

Answer 1

•Skin, ingestion, inhalation by absorption
•Accidenta, suicidal, intentional or unintentional, nerve agents

Question 2

What are some effects of OPCs on the CNS?

Answer 2

EarlyExcitation:restlessness, confusion, ataxia, tremors, seizures.
Then inhibition:coma, apnea

Question 3

What is the mechanism of action for OPCs?

Answer 3

Cholinergic agonist that inactivates acetylcholinesterase (AchE) by phosphorylation(aging) so inc Ach

Question 4

What is the aging phenomenon in relation to OPCs?

Answer 4

The irreversible bond formed by phosphorylation of AchE.

Question 5

What is the effect of OPC on muscarinic ?

Answer 5

Diarrhea, urination, miosis (pinpoint pupils), bronchorrhea, brochospasm, bradycardia, hypotension, lacrimation, pulmonary edema, sweating&subnormal temp.

Question 6

What are the nicotinic symptoms of OPC poisoning?

Answer 6

Fasciculations, muscle cramps, weakness, paralysis, tachycardia, hypertension.

Question 7

What are the cardiac effects associated with OPCs?

Answer 7

Sinus bradycardia, sinus tachycardia, atrial fibrillation, ventricular tachycardia, extrasystole.

Question 8

What is the time frame for intermediate syndrome after OPC exposure?

Answer 8

Can occur up to a week after exposure.

Question 9

What are the respiratory effects of OPC poisoning?

Answer 9

Respiratory muscle weakness and potential respiratory failure.

Question 10

What is delayed neuropathy in relation to OPCs?

Answer 10

Mixed sensory-motor symptoms that may develop in an ascending manner.
Dx more than px

Question 11

What investigations are done for OPCs?

Answer 11

AchE level: true(better), pseudo(available)
ECG,
ABG:respiratory and metabolic acidosis
electrolytes: hypokalemia and magnesmia
LFT, KFT.
Gluocse: hyperglycaemia

Question 12

What is a common metabolic condition associated with OPCs?

Answer 12

Metabolic acidosis and respiratory acidosis.

Question 13

What is the ABCD approach in treating OPCs?

Answer 13

Airway Control, Adequate Oxygenation, Intubation if necessary.

Question 14

What is the role of Atropine in OPC treatment?

Answer 14

Administered after oxygenation to avoid arrhythmias.

Question 15

When can a patient be discharged after OPC treatment?

Answer 15

After Atropinization and observation for neuro symptoms, if asymptomatic and no need for oxygen or Atropine for 1 to 2 days.

Question 16

What is involved in the decontamination process for OPCs?

Answer 16

•Dermal
•Oral: GL&AC

Question 17

What is the dosage of Atropine for adults?

Answer 17

1-2 mg IV.

Question 18

What is the dosage of Atropine for pediatric patients?

Answer 18

0.03 - 0.05 mg/kg IV.

Question 19

When should Atropine be stopped?

Answer 19

When there is dry lung and relief of bronchospasm.

Question 20

What supportive measures are taken in OPC treatment?

Answer 20

Mechanical ventilation.
IV fluids
correction of electrolytes.
Manage arrhythmia
Diazepam with oxides to dec inc of seizures

Question 21

What are oximes used for in OPC treatment?

Answer 21

Anti: •muscarinic •nicotinic •CNS
Protection from intermediate syndrome

Question 22

What is the role of Diazepam with oximes?

Answer 22

Used to manage the incidence of seizures.

Question 23

What is the importance of Atropine premedication?

Answer 23

Anti-muscarinic only