ABSTRACT
Organophosphates poison insects and mammals primarily by phosphorylation of the acetylcholinesterase enzyme at nerve endings. The enzyme is critical to normal control of nerve impulse transmission from nerve fibers to muscle and gland cells, and also to other nerve cells in autonomic ganglia and in the brain. Organophosphates are efficiently absorbed by inhalation, ingestion, and skin penetration. Symptoms of acute organophosphate poisoning develop during exposure, or within 12 hours of contact. The most commonly reported early symptoms are headache, nausea, and dizziness. Detection of intact organophosphates in the blood is usually not possible, except during or soon after absorption of substantial amounts. Slow administration of pralidoxime is strongly recommended and may be achieved by administering the total dose in 250 ml of 5% glucose solution over 30 minutes, or longer. Blood pressure should be monitored during administration because of the occasional occurrence of hypertensive crisis.
