Tx for pesticide exposure

Question 1

What Pesticide exposure?
Causes irreversible cholinesterase inhibition
Symptoms
-Mild: Headache, dizziness, weakness, anxiety, miosis (pupil constriction), nausea and visual impairment.
-Moderate: Nausea, salivation, lacrimation, abdominal cramps, vomiting, diarrhea, sweating, slow pulse, respiratory compromise, and muscle tremors.
-Severe: Pinpoint and non-reactive pupils, respiratory difficulty, pulmonary edema, muscle spasms, cyanosis, loss of sphincter control, convulsions, coma and eventual death due to respiratory failure.

Answer 1

Organophosphates.

Question 2

Organophosphates Treatment:

Answer 2

(a) After cyanosis is overcome, give 2 to 4 mg of atropine sulfate intravenous (IV).
(b) Repeat doses at 5 to 10 minutes until atropinization appear.
(c) Maintain treatment 24 hours or longer.
(d) 2 PAM Chloride, 1 gm IV slowly, may be used for supportive therapy.

Question 3

What Pesticide Exposure?
-Reversible cholinesterase inhibition.
-Signs and symptoms:
Pupillary constriction, salivation, profuse sweating, lassitude, muscle incoordination, nausea and vomiting, diarrhea, epigastric pain, tightness in the chest

Answer 3

Carbamate poisoning

Question 4

Carbamate poisoning Treatment

Answer 4

(a) After cyanosis is overcome, give 2-4 mg atropine sulfate IV
(b) Repeat doses at 5 to 10 minutes until atropinization.
(c) Maintain treatment 24 hours or longer.
(d) 2-pam chloride is contraindicated.

Question 5

What Pesticide exposure?
Central nervous system depressant/stimulants
-Sign and symptoms
Within 20 minutes - 4 hours may have headache, nausea and vomiting, restlessness, tremor, apprehension, convulsion, coma, respiratory failure and death.

Answer 5

Organochlorine pesticide poisoning

Question 6

Organochlorine pesticide poisoning Tx

Answer 6

(a) Do not induce vomiting if the ingested poison is principally an organic solvent.
(b) Lavage stomach with 2-4 liters of tap water.
(c) Induce catharsis with 30 gm sodium sulphate in one cup of water.
(d) Administer barbiturates in appropriate doses repeated as necessary for restlessness or convulsions.
(e) Avoid oils, oil laxatives, or epinephrine.
(f) Do not give stimulants.
(g) Give calcium gluconate (10% in 10 mL ampules) IV q 4 hours.
(h) Refer to current poisoning references for specific/current treatments.