A patient presents to emergency with the pinpoint pupil, salivation lacrimation, tremors, and red tears. Plasma cholinesterase level Was 30% of normal. Most probable Diagnosis is:
ref: KD Tripathi 7th edition (105,110),katzung 12/e p110 These are characteristic features of anti-cholinestearse (organophosphate and carbamate) poisoning. Features of Organophosphate poisoning: Muscarinic symptoms: Pin point pupil, salivation,lacrimation, urination, defecation, gastrointestinal distress, vomiting, bronchospasm, bradycardia Nicotinic symptoms: Fasciculations and fibrillations:of muscle, tachycardia, tachypnea CNS svmptoms: Temors, giddiness, ataxia, coma Red tears: Due to accumulation of porphyrin in the lacrimal glands
Organophospahte Poisoning
Dhatura Poisoning
Opioid Poisoning
Pontine hemorrhage
Autonomic nervous system