Ronald Chrisbianto Gani

405090223
Faculty of Medicine
Tarumanagara University
EMERGENCY MEDICINE BLOCK
CHOLINESTERASE
INHIBITORS POISONING
CHOLINESTERASE INHIBITORS
POISONING
ORGANOPHOSPATES
Inhibition of acetylcholinesterase
accumulation of acetylcholine
Altered neurologic and cognitive function
Some agents (Triorthocresyl phosphate) cause
organophosphorus ester-induced delayed
polyneuropathy (OPIDP) chronic exposure

Katzung Basic & Clinical Pharmacology 11th Ed
CLINICAL FEATURES
Acute :
miosis, salivation, sweating, bronchial
constriction, vomiting, and diarrhea
Central nervous system involvement (cognitive
disturbances, convulsions, and coma)
Katzung Basic & Clinical Pharmacology 11th Ed
MANAGEMENT
Maintenance of vital
Decontamination to prevent further
absorption
Atropine IV in large doses.
Pralidoxime
Benzodiazepine for seizures

Katzung Basic & Clinical Pharmacology 11th Ed
CARBAMATES
Shorter duration of clinical effects
Higher lethality rates
Use of pralidoime is not recommended
Katzung Basic & Clinical Pharmacology 11th Ed