Organophosphate toxicity - Revision history

Danbot: Add peer-reviewed references with PMIDs

2026-03-22T09:59:59Z

Add peer-reviewed references with PMIDs

← Older revision		Revision as of 09:59, 22 March 2026
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	*[[Carbamate]] poisoning (e.g. aldicarb, carbaryl, physostigmine) produces an identical cholinergic toxidrome		*[[Carbamate]] poisoning (e.g. aldicarb, carbaryl, physostigmine) produces an identical cholinergic toxidrome
	*Key difference: carbamates reversibly inhibit AChE → shorter duration, spontaneous recovery		*Key difference: carbamates reversibly inhibit AChE → shorter duration, spontaneous recovery
	*Carbamates do not undergo aging → pralidoxime is generally not needed (and its role is controversial)		*Carbamates do not undergo aging → pralidoxime is generally not needed (and its role is controversial)<ref>Eddleston M, et al. Management of acute organophosphorus pesticide poisoning. Lancet. 2008;371(9612):597-607. PMID 17706760</ref>
	*Carbamate toxicity is typically less severe and shorter-lasting<ref name="iemep">{{cite web \|title=Organophosphate and Carbamate Poisoning (2024) \|url=https://iem-student.org/2024/12/20/organophosphate-and-carbamate-poisoning-2024/ \|website=International Emergency Medicine Education Project \|date=December 26, 2024 \|access-date=February 28, 2026}}</ref>		*Carbamate toxicity is typically less severe and shorter-lasting<ref name="iemep">{{cite web \|title=Organophosphate and Carbamate Poisoning (2024) \|url=https://iem-student.org/2024/12/20/organophosphate-and-carbamate-poisoning-2024/ \|website=International Emergency Medicine Education Project \|date=December 26, 2024 \|access-date=February 28, 2026}}</ref>

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	*Can last for days to weeks		*Can last for days to weeks
	*Thought to result from prolonged NMJ dysfunction due to sustained cholinergic overstimulation		*Thought to result from prolonged NMJ dysfunction due to sustained cholinergic overstimulation
	*Pralidoxime and atropine do NOT prevent or treat the intermediate syndrome<ref name="cureus">{{cite journal \|last1=Patel \|first1=A \|last2=Chavan \|first2=G \|last3=Nagpal \|first3=AK \|title=Navigating the Neurological Abyss: A Comprehensive Review of Organophosphate Poisoning Complications \|journal=Cureus \|volume=16 \|issue=2 \|pages=e54329 \|year=2024 \|doi=10.7759/cureus.54329}}</ref>		*Pralidoxime and atropine do NOT prevent or treat the intermediate syndrome<ref>Roberts DM, Aaron CK. Management of acute organophosphorus pesticide poisoning. BMJ. 2007;334(7594):629-634. PMID 17379909</ref><ref name="cureus">{{cite journal \|last1=Patel \|first1=A \|last2=Chavan \|first2=G \|last3=Nagpal \|first3=AK \|title=Navigating the Neurological Abyss: A Comprehensive Review of Organophosphate Poisoning Complications \|journal=Cureus \|volume=16 \|issue=2 \|pages=e54329 \|year=2024 \|doi=10.7759/cureus.54329}}</ref>

	===Organophosphate-Induced Delayed Neuropathy (OPIDN)===		===Organophosphate-Induced Delayed Neuropathy (OPIDN)===

Danbot: Strip excess bold

2026-03-22T09:30:49Z

Strip excess bold

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Danbot: Add MedicationDose SMW entries for atropine, pralidoxime, diazepam (adult + pediatric); doses verified against AHA/toxicology guidelines

2026-03-20T17:36:30Z

Add MedicationDose SMW entries for atropine, pralidoxime, diazepam (adult + pediatric); doses verified against AHA/toxicology guidelines

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 *'''Psychiatry''': Mandatory for intentional ingestions
 *'''If EMS can identify the specific product/label''': Bring it in — different OPs have different aging times, which directly impacts whether pralidoxime will be effective<ref name="medscape"/>
 ==See Also==

Ostermayer at 23:49, 28 February 2026

2026-02-28T23:49:44Z

← Older revision		Revision as of 23:49, 28 February 2026
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	{{Cholinergic Toxicity Treatment}}		{{Cholinergic Toxicity Treatment}}

	=
	====Benzodiazepines====		====Benzodiazepines====
	*'''Diazepam''' or '''midazolam''' for [[seizures]]<ref name="statpearls"/>		*'''Diazepam''' or '''midazolam''' for [[seizures]]<ref name="statpearls"/>

Ostermayer at 23:48, 28 February 2026

2026-02-28T23:48:48Z

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 {{Cholinergic Toxicity Treatment}}
-====Atropine====
 ====Benzodiazepines====
 *'''Diazepam''' or '''midazolam''' for [[seizures]]<ref name="statpearls"/>

Ostermayer at 23:37, 28 February 2026

2026-02-28T23:37:03Z

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Rossdonaldson1: /* Background */

2023-10-03T22:24:19Z

Background

← Older revision		Revision as of 22:24, 3 October 2023
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	*[[Organophosphates]] found in:		*[[Organophosphates]] found in:
	**Pesticides (e.g. malathion, diazinon)		**Pesticides (e.g. malathion, diazinon)
	**[[Chemical weapons]] (e.g. Sarin, nerve agents has been used as chemical weapon		**[[Chemical weapons]] (e.g. Sarin, nerve agents has been used as chemical weapon)
	**medications (e.g. [[neostigmine]], [[edrophonium]]		**medications (e.g. [[neostigmine]], [[edrophonium]]
	*Highly lipid soluble: absorbed via dermal, gastrointestinal or respiratory routes		*Highly lipid soluble: absorbed via dermal, gastrointestinal or respiratory routes

Beren85: /* Clinical Features */

2019-08-31T15:23:49Z

Clinical Features

← Older revision		Revision as of 15:23, 31 August 2019
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	*Muscarinic Receptors		*Muscarinic Receptors
	**SLUDGE(M) = '''S'''alivation, '''L'''acrimation, '''U'''rination, '''D'''iarrhea, '''G'''I pain, '''E'''mesis, '''M'''iosis		**SLUDGE(M) = '''S'''alivation, '''L'''acrimation, '''U'''rination, '''D'''iarrhea, '''G'''I pain, '''E'''mesis, '''M'''iosis
			**DUMBELLS = '''D'''iarrhea, diaphoresis, '''U'''rination, '''M'''iosis, '''B'''radycardia, '''B'''ronchorrea, '''E'''mesis, '''L'''acrimation, '''L'''ethargic, '''S'''alivation
	*Nicotinic Receptors (NMJ)		*Nicotinic Receptors (NMJ)
	**MTWThF = '''M'''ydriasis/Muscle cramps, '''T'''achycardia, '''W'''eakness, '''T'''witching, '''H'''ypertension/Hyperglycemia, '''F'''~~asiculations~~		**MTWThF (days of week) = '''M'''ydriasis/Muscle cramps, '''T'''achycardia, '''W'''eakness, '''T'''witching, '''H'''ypertension/Hyperglycemia, '''F'''asciculations, '''S'''eizures, '''S'''omnolent
	*Common causes of death in [[organophosphate]] toxicity		*Common causes of death in [[organophosphate]] toxicity
	**Killers B's = '''B'''radycardia, '''B'''ronchorrhea, '''B'''ronchospasm		**Killers B's = '''B'''radycardia, '''B'''ronchorrhea, '''B'''ronchospasm

ClaireLewis at 18:51, 22 August 2019

2019-08-22T18:51:49Z

← Older revision		Revision as of 18:51, 22 August 2019
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	==Clinical Features==		==Clinical Features==
	*Symptoms caused by acetylcholine buildup in CNS and PNS.		*Symptoms caused by acetylcholine buildup in CNS and PNS.
	*CNS symptoms = headache, confusion, seizures coma~~, vertigo~~		*CNS symptoms = [[headache]], [[confusion]], [[vertigo]], [[seizures]], [[coma]]
	*Muscarinic Receptors		*Muscarinic Receptors
	**SLUDGE(M) = '''S'''alivation, '''L'''acrimation, '''U'''rination, '''D'''iarrhea, '''G'''I pain, '''E'''mesis, '''M'''iosis		**SLUDGE(M) = '''S'''alivation, '''L'''acrimation, '''U'''rination, '''D'''iarrhea, '''G'''I pain, '''E'''mesis, '''M'''iosis
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	*Comprehensive Metabolic Panel		*Comprehensive Metabolic Panel
	*[[CXR]]		*[[CXR]]
	**Pulmonary edema in severe cases		**[[Pulmonary edema]] in severe cases
	*[[ECG]]		*[[ECG]]
	**Ventricular dysrhythmias, torsades, QT prolongation, AV block		**[[Ventricular dysrhythmias]], [[torsades]], [[QT prolongation]], [[AV block]]

	===Diagnosis===		===Diagnosis===

ClaireLewis: /* Background */

2019-01-27T22:02:11Z

Background

← Older revision		Revision as of 22:02, 27 January 2019
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	**Pesticides (e.g. malathion, diazinon)		**Pesticides (e.g. malathion, diazinon)
	**[[Chemical weapons]] (e.g. Sarin, nerve agents has been used as chemical weapon		**[[Chemical weapons]] (e.g. Sarin, nerve agents has been used as chemical weapon
	**~~[[Acetylcholinesterase inhibitor]]~~ medications (e.g. [[neostigmine]], [[edrophonium]]		**medications (e.g. [[neostigmine]], [[edrophonium]]
	*Highly lipid soluble: absorbed via dermal, gastrointestinal or respiratory routes		*Highly lipid soluble: absorbed via dermal, gastrointestinal or respiratory routes
	*Colorless, odorless, low volatility, and high lipophilicity		*Colorless, odorless, low volatility, and high lipophilicity
	*These compounds ~~block~~ acetylcholinesterase, resulting in excess accumulation of acetylcholine at the neuromuscular junction and [[cholinergic crisis\|cholinergic toxicity]]		*These compounds act as [[Acetylcholinesterase inhibitors]]
			**Block acetylcholinesterase, resulting in excess accumulation of acetylcholine at the neuromuscular junction and [[cholinergic crisis\|cholinergic toxicity]]
	*LD50 of 0.04mg/kg (10 mg). Death can occur within 15 minutes after absorption		*LD50 of 0.04mg/kg (10 mg). Death can occur within 15 minutes after absorption