Organophosphorus pesticide poisoning symptoms and first aid to deal with

Contact: organophosphorus pesticide production and use of personnel. Invasive ways: through the skin, respiratory, gastrointestinal absorption. Toxicology: All varieties can be toxic, most are highly toxic and highly toxic category, for a small number of low toxicity category. Some hybrid varieties from time to time by the use of drugs, such as malathion and trichlorfon, and trichlorfon Valley, such as parathion mixture. Some varieties can be converted into and by drugs, such as the oxidation of 1605 after increasing toxicity, trichlorfon in alkaline solution into a more toxic and dichlorvos. Organophosphorus pesticides (organophosphate pesticides) in the body and the formation of cholinesterase DIPP AChE, acetylcholinesterase activity was inhibited, so that enzymes can not break down from the role of acetylcholine, tissue caused by excessive accumulation of acetylcholine So that the cholinergic neurons over-excited, caused by muscarinic and nicotinic and central nervous system symptoms. DIPP enzyme choline esterase in general about 48 hours after the "aging" is not easy to resume. Some of the aromatic esters and alkyl phosphate-based compounds are still delayed neurotoxicity, is due to organophosphorus pesticides inhibit the body neuropathy target esterase (EST neurotoxicity), and "aging", caused by delayed Neuropathy. This toxic effect has nothing to do with the cholinesterase activity. Sustained-release microcapsules of organophosphorus pesticide formulations, the time may be longer. Clinical manifestations: Acute poisoning The incubation period: the concentration of the species and pesticides, and the way the body to absorb the situation to another. General through the skin to absorb more than 2 to 6 hours in the incidence of respiratory tract after oral inhalation or more in the 10-2 minutes incidence. Symptoms: poisoning caused by a variety of ways to absorb the performance of similar, but the symptoms can be different. If the skin is often first appear mainly to absorb sweat, salivation, irritability, and so on; oral poisoning often appear to nausea, vomiting, abdominal pain and other symptoms; respiratory tract when inhaled toxic Shiwumohu symptoms such as difficulty breathing and can happen faster . According to the site and the role of drug-induced symptoms: a. muscarinic-like symptoms: loss of appetite, nausea, vomiting, abdominal pain, diarrhea, salivation, hyperhidrosis, Shiwumohu, reduce pupil, the increase in respiratory secretions, bronchospasm, dyspnea, pulmonary edema. b. nicotine-like symptoms: muscle bundle fibrillation, decreased muscle strength, muscle cramps, respiratory muscle paralysis. c. central nervous system symptoms: headache, dizziness, fatigue, weakness, drowsiness or insomnia, irritability, confusion, unclear language, delirium, convulsions, coma, respiratory center inhibition caused by respiratory arrest. d. autonomic nervous system symptoms: high blood pressure, heart rate accelerated progress of the disease occurs when heart rate, cardiac arrhythmia. Classification poisoning a. mild poisoning: there is dizziness, headache, nausea, vomiting, sweating, chest tightness, Shiwumohu, not symptoms, may reduce the pupil. Whole blood cholinesterase activity in general 50% to 70%. b. moderate poisoning: add to the above-mentioned symptoms, the band still vibrate, to reduce the pupil, mild dyspnea, salivation, abdominal pain, diarrhea, hobbled gait, or the sense of fuzzy-ching. Whole blood cholinesterase activity in general 30% to 50%. c. severe poisoning: In addition to the above symptoms, there are pulmonary edema, coma, respiratory paralysis or brain edema. Whole blood cholinesterase activity in general below 30%. Delayed sudden death: dimethoate, trichlorfon serious poisoning recovery period can be sudden death. Often after the poisoning occurred in 3 to 15. Were found in oral poisoning. Intermediate syndrome: fenthion, dimethoate, monocrotophos, dichlorvos, methamidophos, such as poisoning after 2 to 4 days, appears to proximal limb muscles, cervical flexion and extension movement at the disposal of nerve and muscle respiratory muscle Inability of the main clinical features, including the rise of shoulder, hip flexor and difficult to open eyes, limited eye movements, double vision, facial expression muscle movement restricted, hoarse voice, chewing and swallowing difficulties may be due to respiratory muscle paralysis and死亡. Delayed peripheral neuropathy: methamidophos, propylamine phosphorus, fluorine C P, parathion, malathion, Yi Pien, dimethoate, dichlorvos, trichlorfon, propylamine phosphate fluoride poisoning, such as the resumption of the disease after 4 to 45 Day of limbs feeling - Sports polyneuropathy. Has nothing to do with the cholinesterase activity. Ruyan splash of pesticides within the pupil can cause reduced, there may not be poisoning the body. First-aid deal with: Too much contact away from the scene immediately to fresh air. Contamination of the skin immediately with plenty of water or soapy water rinse. Eye contamination of irrigation water use. Oral gastric lavage were detained after the stomach in order to pesticides reflux can be cleaned again, such as oral dimethoate after gastric tube should be kept 2 to 3 days, regular cleaning. Can not stomach when the gastric lavage for gastrostomy tube gastric lavage. Mild muscarinic, or nicotine-like symptoms of central nervous system, blood cholinesterase activity were normal; no obvious symptoms, whole blood cholinesterase activity below 70%; contact or large, are Observation should be 24 to 72 hours, to deal with in a timely manner. Effects antidote: a. atropine: to remove or reduce the muscarinic and central nervous system symptoms, improve the respiratory center inhibition. Use principles: early, regular and repeated drug delivery, quick reach, "atropine" (the pupil to expand, facial flushing, skin sweat-free, dry mouth, accelerated heart rate). Usage: mild poisoning, each 1 ~ 2mg, or subcutaneous injection every 4 to 6 hours 1 to reach "atropine" changed after the oral 0.3 ~ 0.6mg, day 2 or 3 times. Moderate poisoning, for the first time 2 ~ 5mg, intravenous injection. Severe poisoning for the first time 10 ~ 20mg, intravenous injection, such as the muscarinic-like symptoms did not improve or not "of Atropine," is 5 to 10 minutes later to repeat the whole or half the amount; can also be used to maintain the intravenous drug, at any time to adjust Dose, amounting to "atropine" until the muscarinic-like symptoms improved significantly in favor of maintaining the volume. If the symptoms subside basic signs, the reduction can be observed for 12 hours, such as non-recurring illness, drug withdrawal. Mild poisoning can be a separate application of atropine, moderate and severe poisoning when the merger application of atropine and cholinesterase agent can resume. There are drugs merger synergies, the appropriate dose should be reduced. Ruyan splash with a small amount of pesticides to reduce pupil caused no systemic symptoms of poisoning, with no need for systemic treatment of atropine, the application of 0.5% to 1% atropine drops can be.