A case report of cholinesterase inhibitor poisoning: cholinesterase activities and analytical methods for diagnosis and clinical decision making.
Arch Toxicol
; 94(6): 2239-2247, 2020 06.
Article
em En
| MEDLINE
| ID: mdl-32303803
ABSTRACT
Suicidal ingestion of organophosphorus (OP) or carbamate (CM) compounds challenges health care systems worldwide, particularly in Southeast Asia. The diagnosis and treatment of OP or CM poisoning is traditionally based on the clinical appearance of the typical cholinergic toxidrome, e.g. miosis, salivation and bradycardia. Yet, clinical signs might be inconclusive or even misleading. A current case report highlights the importance of enzymatic assays to provide rapid information and support clinicians in diagnosis and rational clinical decision making. Furthermore, the differentiation between OP and CM poisoning seems important, as an oxime therapy will most probably not provide benefit in CM poisoning, but-as every pharmaceutical product-it might result in adverse effects. The early identification of the causing agent and the amount taken up in the body are helpful in planning of the therapeutic regimen including experimental strategies, e.g. the use of human blood products to facilitate scavenging of the toxic agent. Furthermore, the analysis of biotransformation products and antidote levels provides additional insights into the pathophysiology of OP or CM poisoning. In conclusion, cholinesterase activities and modern analytical methods help to provide a more effective treatment and a thorough understanding of individual cases of OP or CM poisoning.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Acetilcolinesterase
/
Butirilcolinesterase
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Inibidores da Colinesterase
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Ensaios Enzimáticos Clínicos
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Intoxicação por Organofosfatos
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged80
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Humans
Idioma:
En
Revista:
Arch Toxicol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Alemanha