A farmer presented in OPD clinic with sweating, lacrimation, pin-point pupils with a heart rate of 40/min. Possible diagnosis:
(Ref: Katzung Pharmacology, 14th ed. pg. 115)Organophosphates are irreversible Acetylcholinesterase inhibitor which is well absorbed from the skin, lung, gut, and conjunctiva--thereby making them dangerous to humans and highly effective as insecticides.Due to inhibition of acetylcholinesterase enzyme, acetylcholine levels are increased and the patient therefore presents with cholinergic symptoms: (Mn: SLUDGE-FB)Salivation, Lacrimation, increased urination, Diarreha, GI distress, Emesis, Faciculation, BradycardiaDOC for this poisoning: ATROPINEOXIMES (Pralidoximes, Di-Acetyl monoxime) are known as AchE enzyme reactivators. These are used only in organophosphate poisoning.Pin-point pupil is seen in poisoning with: (Mn: POMP)Pontine hemorrhage, Organophosphate, Morphine and Phenol poisoning
Dhatura poisoning
Organophosphate poisoning
Atropine poisoning
Cocaine poisoning
A.N.S.