Zoofaghari Shafeajafar, Maghami-Mehr Asieh, Abdolrazaghnejad Ali
Department of Clinical Toxicology, Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Statistics, Yazd University, Yazd, Iran.
Adv Biomed Res. 2024 Sep 23;13:82. doi: 10.4103/abr.abr_393_22. eCollection 2024.
The high annual mortality rate of organophosphorus (OP) poisoning indicates that the treatment is mostly ineffective in this regard. It has been suggested to add calcium channel blocking (CCB) drugs or magnesium sulfate (MgSO) to normal care to decrease the release of acetylcholine (ACh) at the cholinergic synapse. Moreover, the diagnosis of OP poisoning is chiefly based on clinical evidence. Oximes and atropine are the recognized antidotes of OP. However, low-priced medications such as MgSO and sodium bicarbonate (NaHCO), as well as novel adjunct therapies, have been introduced recently. Furthermore, antioxidants are recommended for managing OP poisoning. In addition, hemoperfusion, fresh frozen plasma (FFP), and K-oximes are a number of innovative management modalities that deserve further evaluation. However, prevention seems to be the most effective management modality in this respect. Therefore, this study aimed to briefly discuss the controversies in OP poisoning management and present recent advances in its management and prognosis. The results of this study revealed that multiple factors including type of exposure, acetylcholinesterase (AChE) plasma level, time of hospitalization, and severity confirming OP poisoning should be considered to provide the best treatment strategy.
有机磷(OP)中毒的年死亡率很高,这表明在这方面的治疗大多无效。有人建议在常规治疗中添加钙通道阻滞剂(CCB)药物或硫酸镁(MgSO),以减少胆碱能突触处乙酰胆碱(ACh)的释放。此外,OP中毒的诊断主要基于临床证据。肟类和阿托品是公认的OP解毒剂。然而,最近引入了一些低价药物,如MgSO和碳酸氢钠(NaHCO),以及新型辅助疗法。此外,建议使用抗氧化剂来处理OP中毒。此外,血液灌流、新鲜冰冻血浆(FFP)和K-肟是一些值得进一步评估的创新治疗方式。然而,在这方面预防似乎是最有效的治疗方式。因此,本研究旨在简要讨论OP中毒管理中的争议,并介绍其管理和预后的最新进展。本研究结果表明,为了提供最佳治疗策略,应考虑多种因素,包括接触类型、血浆乙酰胆碱酯酶(AChE)水平、住院时间以及确诊OP中毒的严重程度。