Poisoning with organophosphorous connections
Contents:
Description:
Acute poisoning with organophosphorous connections (FOS) among poisonings with toxic chemicals has big specific weight — 40 — 50%.
Reasons of poisoning with organophosphorous connections:
Organophosphorous connections (FOS) widely use in agriculture and life as means of fight against insects, rodents, weed plants. Poisonings can have seasonal and mass nature.
Toxic doses. On L. I. Medvedya's classification allocate the following groups of toxic substances:
- silnoyadovity (DL50 less 50mg/kg): thiophos (parathion, парафос), metaphos (methylparathion, metacide), mercaptophos (systox, деметон, внуран), octamethyl (шрадан);
- highly toxic (DL50 - 200mg/kg): methylmercaptophos (marked systox, метилдеметон), phosphamide (диметоат, дитрол, a rogor), дихлорфос (vapona, vinylphosphate, DDVF), этион, phthalophos;
- average degree of toxicity (DL50 - 200 - 1000 mg/kg): хлорофос (диптерекс, диплокс, трихлорфон), karbofos (малатон, malathion), метилнитрофос (sumithion, фолитион, метилхлортион), sayfos, трибуфос, цианофос;
- low-toxic (DL50 is higher than 1000 mg/kg): bromophos, демуфос, темефос.
Pathogeny:
FOS inhibit cholinesterase enzymes, generally the acetylcholinesterase destroying acetylcholine. Thereof there is an accumulation of acetylcholine that leads to excitement, and in an effect to exhaustion and persistent paralysis of cholinergic structures. Acetylcholine carries out function of a mediator in the following structures:
- synapses of the postganglionic parasympathetic nerve fibrils (muskarinochuvstvitelny, or M-holinoretseptorakh) innervating internals, unstriated muscles and heart and also postganglionic sympathetic nerve fibrils, to an innervir their sweat glands;
- in all gangliya, and also in neyromychny synapses of cross ischerchenny muscles (nicotinosensitive, or N-holinoretseptorakh);
- in M - and N - TsNS holinoretseptor. Communication of FOS with cholinesterase fragile within teovy seconds, in the next several hours it be stabilized and becomes strong approximately in 5 h.
Symptoms of poisoning with organophosphorous connections:
Symptoms of poisoning are shown through 2-4 and after implementation of substances in an organism.
Distinguish 3 degrees (stage) of poisoning.
— At easy degree the miosis (narrowing of a pupil), a severe headache, breath difficulty, fear, excitement develops, there are wet rattles in lungs, perspiration, the ABP raises.
— At poisoning of average degree the accommodation spasm, decrease in sight, nausea, vomiting, a diarrhea, suffocation, dizziness, sweat — and salivation, concern, fear, hallucinations, spasms, bradycardia, hypotonia join.
— The severe form is followed by oppression of a respiratory center, a bronchospasm, paralyzes of extremities, falling of the ABP, disturbance of a cordial rhythm and conductivity. From a mouth and washing waters ikhsodit a thiophos smell. To differentiate from poisonings with mushrooms, a nitrogen oxide.
Treatment of poisoning with organophosphorous connections:
Antidotes of pathogenetic action:
a) atropine intramusculary, in hard cases — intravenously, 0,1% solution, 1 ml (repeated injections depending on expressiveness of a miosis);
b) cholinesterase reaktivator — dipiroksy, 15% solution, 1 ml, subcutaneously or intramusculary, intravenously (depending on severity on a course of treatment — 0,3 — 1 g), or Isonitrosinum, 40% solution, 3 ml intramusculary, intravenously (on a course of treatment — to 3 g);
c) reaktivator of cholinesterase of the central action — alloksy, 0,075 g (it is dissolved in 1 ml of the distilled water) intramusculary (a daily dose — 0,4 — 1,6
d) the main antidote at average and heavy degree of poisoning.
2. In the presence of N - cholinergic reactions — ganglio-blockers: Pentaminum, 5% solution, to 1 ml, or petrolhexonium, 2,5% solution, to 1 ml, in 5% or 10% glucose solution, to 10 — 20 ml (enter 1 — 2 ml of solution under control of the ABP).
5. Disintoxication therapy — Haemodesum, reopoli-glyukin, plasma.
4. The antioxidant therapy and means protecting liver cells (lipostabit, Essentiale, cocarboxylase, lipoic acid).
