DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20150869

Study on organophosphate poisoning analysis and pharmacotherapeutic outcome in tertiary care hospital

Shreenivas P. Revankar, H. Vedavathi

Abstract


Background: Organophosphate (OP) poisoning is the most common cause of poisoning and suicides in rural India as it is easily available and more often used in agriculture as a pesticide. In the present days, death due to OP is mainly due to draught, scarcity of rains and debt.

Methods: The main objective of the study was to know the sociodemographic patterns, mode of presentation and outcome of treatment in the OP poisoning case that were admitted and treated in the tertiary care hospital attached to SIMS Shimoga. The study was a retrospective which included 120 patients at the point.

Results: It was found that OP poisoning was commoner in males than in females. The male: female ratio was 1.5:1. OP associated deaths were the more common in agriculture based socioeconomic group than others mainly due to easy accessibility. Muscarinic manifestations were the common presentation in most of the patients. It was found that in the majority of the cases atropine and pralidoxime were the commonly used antidotes and recover rate was 93%.

Conclusion: Consumption of large doses of OP and delayed treatment due to late admission were associated with increased mortality. Awareness programs regarding safe use and strict policies governing the availability of OP will help in saving many lives due to OP poisoning.


Keywords


Organophosphate, Retrospective, Atropine, Pralidoxime, Recovery, Mortality

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References


Jeyaratnam J. Acute pesticide poisoning: a major global health problem. World Health Stat Q. 1990;43(3):139-44.

Ramesha KN, Rao KB, Kumar GS. Pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka, India. Indian J Crit Care Med. 2009;13(3):152-5.

Eddleston M. Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000;93(11):715-31.

Eddleston M, Dawson A, Karalliedde L, Dissanayake W, Hittarage A, Azher S, et al. Early management after self-poisoning with an organophosphorus or carbamate pesticide - a treatment protocol for junior doctors. Crit Care. 2004;8(6):R391-7.

Leibson T, Lifshitz M. Organophosphate and carbamate poisoning: review of the current literature and summary of clinical and laboratory experience in southern Israel. Isr Med Assoc J. 2008;10(11):767-70.

Srivastava SK. A Complete Textbook of Medical Pharmacology. 1st Edition., Vol. 1. Dubuque, IA: Avichal Publishing Company; 2009: 122-3.

Udaykumar P. Medical Pharmacology. 3rd Edition. New Delhi: CBS Publishers. 2006: 468-74.

Tripathi KD. Essentials of Medical Pharmacology. 6th Edition. New Delhi: Jaypee Publications; 2013: 98.

Brenner GM, Stevens CW. Pharmacology. 3rd Edition. Cheltenham: Elsevier Publishers; 2012: 473-7.

Linden CH, Burns MJ, Mycyk MB. Poisoning and drug over dosage. In: Kasper DL, Fauci AS, Longo DL, Jameson JL, Loscalzo J, Hauser SL, editors. Harrison’s Principles of Internal Medicine. 17th Edition. New York: The McGraw-Hill Companies, Inc.; 2008: e35:e281.

Eddleston M, Szinicz L, Eyer P, Buckley N. Oximes in acute organophosphorus pesticide poisoning: a systematic review of clinical trials. QJM. 2002;95(5):275-83.

Thomas M, Anandan S, Kuruvilla PJ, Singh PR, David S. Profile of hospital admissions following acute poisoning – experiences from a major teaching hospital in south India. Adverse Drug React Toxicol Rev. 2000;19(4):313-7.

Senanayake N, de Silva HJ, Karalliedde L. A scale to assess severity in organophosphorus intoxication: POP scale. Hum Exp Toxicol. 1993;12(4):297-9.

Srivastava A, Peshin SS, Kaleekal T, Gupta SK. An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi. Hum Exp Toxicol. 2005;24(6):279-85.

Sheikh JM, Siddiqui FG, Soomro AG. Management of acute organophosphorus insecticide poisoning: an experience at a university hospital. JLUMHS. 2008;7(2):97-101.

Park K. Parks Text Book of Preventive and Social Medicine. 23rd Edition. India: Bhanoth Publishers; 2015: 342-50.