A study on the effectiveness of therapy with different doses of pralidoxime in acute organophosphorus poisoning

Dr. Lubna Tabassum; Dr. Shilpa Avarebeel; Dr. Fareeza Taskeen

Volume : IV, Issue : VII, July - 2015

A study on the effectiveness of therapy with different doses of pralidoxime in acute organophosphorus poisoning

Dr. Lubna Tabassum, Dr. Shilpa Avarebeel, Dr. Fareeza Taskeen

Abstract :

<p>&nbsp;Background: Organophosphorous (OP) compound poisoning is a major health problem not only in the developing countries but also in western countries. OP compounds are easily available as insecticides in shops and have resulted in a gradual increase in suicidal &amp; accidental poisoning. The diagnosis is based on the history of exposure and features of cholinergic overactivity. Standard treatment includes attempts to reduce OP absorption with gastric lavage and/ or activated charcoal, plus administration of atropine and oximes to counter the cholinergic effects of the pesticide. Although the use of high doses of atropine is well established, the use of oximes is more controversial. Pralidoxime is the oxime most often used worldwide. Objective: In this study we aim to evaluate the efficacy and outcome with different dosages of pralidoxime. Study design: Fifty (50) patients presenting to the emergency department of BGS Apollo hospital, Mysore, between April 2008 to March 2009 with acute organophosphorus compound poisoning were included in the study. All the patients received a bolus dose of 2gm pralidoxime in the emergency room after emergency treatment using a standard protocol, following which patients were randomized into 3 categories depending on the dose of pralidoxime they received, into 250mg, 500mg and 1000mg(1gm) categories. The three groups were evaluated for the parameters and appropriate analysis was done. Various kinds of poisons were encountered in current study, of which Roger was the most common. Results: This study concluded that Dosage of Pralidoxime does not have any significance in patients with organophosphorous compound poisoning with respect to the outcome parameters like Need for Intubation, Duration of Ventillation and Mortality. Also development of Intermediary syndrome is more common with higher dosage of Pralidoxime. Patients receiving high dosage of pralidoxime require longer intensive care management as compared to those receiving low dose of pralidoxime. Development of Respiratory distress does not have any direct correlation with dosage of pralidoxime.</p>