EMERGENCY MEDICINE BLOCK

Ronald Chrisbianto Gani

405090223
Faculty of Medicine
CHOLINESTERASE Tarumanagara University
INHIBITORS POISONING
CHOLINESTERASE INHIBITORS
POISONING
 ORGANOPHOSPATES
• Inhibition of acetylcholinesterase 
accumulation of acetylcholine
• Altered neurologic and cognitive function
• Some agents (Triorthocresyl phosphate) cause
organophosphorus ester-induced delayed
polyneuropathy (OPIDP)  chronic exposure

Katzung Basic & Clinical Pharmacology 11th Ed

 CLINICAL FEATURES
• Acute :
– miosis, salivation, sweating, bronchial
constriction, vomiting, and diarrhea
– Central nervous system involvement (cognitive
disturbances, convulsions, and coma)

Katzung Basic & Clinical Pharmacology 11th Ed

 MANAGEMENT
• Maintenance of vital
• Decontamination to prevent further
absorption
• Atropine IV in large doses.
• Pralidoxime
• Benzodiazepine for seizures

Katzung Basic & Clinical Pharmacology 11th Ed

 CARBAMATES
• Shorter duration of clinical effects
• Higher lethality rates
• Use of pralidoime is not recommended

Katzung Basic & Clinical Pharmacology 11th Ed