The Japanese Journal of Clinical Dialysis Vol.18 No.8(2-2-3)

Theme Intoxication of Drugs and Poisons and Blood Purification Therapy (Case Report)
Title Treatment of acute organophosphate poisoning
Publish Date 2002/07
Author Takanori Ishii Department of Nephrology, Oita City Medical Association's Almeida Memorial Hospital
[ Summary ] The body readily absorbs organophosphates, whether the route of entry is oral, transdermal, or by inhalation. These agents inhibit acetylcholine esterase and lead to various symptoms via nicotinicaction, muscarinic action, sympathetic nerve stimulation, as well as effects on the central nervous system. For treatment of poisoning symptoms, PAM is used in the early stages, with a requirement for controlled respiration and circulation during administration of atropine to counteract muscarinic actions. However, the most important measure in treating organophosphate poisoning is the use of gastric and intestinal lavage to sufficiently eliminate any unabsorbed organophosphate from the body as rapidly as possible. As an issue regarding "the decreased adsorption capabilities of activated charcoal due to PEG-ELS" exists, future investigation into the composition of lavage solutions is required. While hemo-adsorption is undeniably a symptomatic treatment, its use is presently becoming less prevalent due to concerns such as elimination efficiency and rebound.
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