After helping his father in the yard, a 14-year-old boy complains of weakness and feels like his muscles are twitching. He begins to drool, and then collapses in a generalized tonic-clonic seizure. Upon the arrival of EMS, his heart rate is found to be 40 beats per minute and his pupils are pinpoint. For the most likely toxic substance involved in the cases above, select the appropriate treatment
Organophosphate insecticides are absorbed from all sites and act by inhibiting cholinesterases, thereby leading to the accumulation of high levels of acetylcholine. This affects the parasympathetic nervous system, muscle, and the CNS. Treatment of a patient contaminated with organophosphate insecticide will include thorough washing of the pesticide from the skin, inducing emesis or performing gastric lavage, supporting ventilation, and administering atropine followed by pralidoxime (2-PAM).
Atropine and pralidoxime (2-PAM)
N- acetylcysteine (Mucomyst)
Dimercaptosuccinic acid (DMSA, succimer)
Naloxone (Narcan)
Growth, Development, and Behavior