ABSTRACT
Pathophysiology The stimulatory neurotransmitter acetylcholine acts at cholinergic nerve synapses and neuromuscular junctions. Normally, acetylcholine is catabolized by acetylcholinesterase or other cholinesterases (ChE). OP and carbamate insecticides directly bind and inhibit ChE (Figure 20.1). Toxicity is the result of postsynaptic overstimulation due to the accumulation of acetylcholine.
