TY  - CHAP
AU  - Vučinić, Slavica
AU  - Antonijević, Biljana
AU  - Brkić, Dragica
PY  - 2014
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2263
AB  - Besides being a potential risk to humans and other living organisms, organophosphorus (OP) compounds also poses a risk to the environment. Production and placing pesticides on the market are under national and international legislative framework, although in many developing countries the regulation is still inadequate or not properly enforced. Occupational exposure to OPs includes any job which involves either direct or indirect contact with OP compounds, while public exposure to OPs may occur through contaminated food or from hand-to-mouth contact with contaminated surfaces, inhalation and dermal contact. The aim of this chapter is to present a comprehensive review of control and regulation measures, risk assessment methods, types and modality of occupational and environmental exposure to OPs, and ecotoxicology of these compounds. Review of the literature on OP exposure in electronic bibliographic databases, textbooks, and Internet sources was done. The acute high-dose effects of OPs are well known and include neurological dysfunction due to the inhibition of acetylcholinesterase (AChE), while effects of low-level exposure are still a matter of controversy. Advances in analytical methods help scientists to find new biomarkers of exposure and tools for biological monitoring and regulations of occupational exposure.
PB  - Springer-Verlag London Ltd
T2  - Basic and Clinical Toxicology of Organophosphorus Compounds
T1  - Occupational and environmental aspects of organophosphorus compounds
SP  - 213
EP  - 244
DO  - 10.1007/978-1-4471-5625-3_8
ER  - 

@inbook{
author = "Vučinić, Slavica and Antonijević, Biljana and Brkić, Dragica",
year = "2014",
abstract = "Besides being a potential risk to humans and other living organisms, organophosphorus (OP) compounds also poses a risk to the environment. Production and placing pesticides on the market are under national and international legislative framework, although in many developing countries the regulation is still inadequate or not properly enforced. Occupational exposure to OPs includes any job which involves either direct or indirect contact with OP compounds, while public exposure to OPs may occur through contaminated food or from hand-to-mouth contact with contaminated surfaces, inhalation and dermal contact. The aim of this chapter is to present a comprehensive review of control and regulation measures, risk assessment methods, types and modality of occupational and environmental exposure to OPs, and ecotoxicology of these compounds. Review of the literature on OP exposure in electronic bibliographic databases, textbooks, and Internet sources was done. The acute high-dose effects of OPs are well known and include neurological dysfunction due to the inhibition of acetylcholinesterase (AChE), while effects of low-level exposure are still a matter of controversy. Advances in analytical methods help scientists to find new biomarkers of exposure and tools for biological monitoring and regulations of occupational exposure.",
publisher = "Springer-Verlag London Ltd",
journal = "Basic and Clinical Toxicology of Organophosphorus Compounds",
booktitle = "Occupational and environmental aspects of organophosphorus compounds",
pages = "213-244",
doi = "10.1007/978-1-4471-5625-3_8"
}

Vučinić, S., Antonijević, B.,& Brkić, D.. (2014). Occupational and environmental aspects of organophosphorus compounds. in Basic and Clinical Toxicology of Organophosphorus Compounds
Springer-Verlag London Ltd., 213-244.
https://doi.org/10.1007/978-1-4471-5625-3_8

Vučinić S, Antonijević B, Brkić D. Occupational and environmental aspects of organophosphorus compounds. in Basic and Clinical Toxicology of Organophosphorus Compounds. 2014;:213-244.
doi:10.1007/978-1-4471-5625-3_8 .

Vučinić, Slavica, Antonijević, Biljana, Brkić, Dragica, "Occupational and environmental aspects of organophosphorus compounds" in Basic and Clinical Toxicology of Organophosphorus Compounds (2014):213-244,
https://doi.org/10.1007/978-1-4471-5625-3_8 . .

TY  - JOUR
AU  - Vučinić, Slavica
AU  - Zlatković, Milica
AU  - Antonijević, Biljana
AU  - Ćurčić, Marijana
AU  - Bošković, Bogdan
PY  - 2013
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/1966
AB  - Despite improvements to intensive care management and specific pharmacological treatments (atropine, oxime, diazepam), the mortality associated with organophosphate (OP) poisoning has not substantially decreased. The objective of this examination was to describe the role of fresh frozen plasma (FFP) in acute OP poisoning. After a deliberate ingestion of malathion, a 55-year-old male suffering from miosis, somnolence, bradycardia, muscular fasciculations, rales on auscultation, respiratory insufficiency, as well as from an inhibition of red blood cell acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BuChE), was admitted to hospital. Malathion was confirmed in a concentration of 18.01 mg L-1. Apart from supportive measures (including mechanical ventilation for four days), antidotal treatment with atropine, oxime - pralidoxime methylsulphate (Contrathion (R)), and diazepam was administered, along with FFP. The potentially beneficial effects of FFP therapy included a prompt increase of BuChE activity (from 926 IU L-1 to 3277 IU L-1; reference range from 7000 IU L-1 to 19000 IU L-1) and a reduction in the malathion concentration, followed by clinical recovery. Due to BuChE replacement, albumin content, and volume restitution, FFP treatment may be used as an alternative approach in patients with acute OP poisoning, especially when oximes are not available.
PB  - Inst Medical Research & Occupational Health, Zagreb
T2  - Arhiv za higijenu rada i toksikologiju - Archives of Industrial Hygiene and Toxicology
T1  - Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning
VL  - 64
IS  - 2
SP  - 273
EP  - 277
DO  - 10.2478/10004-1254-64-2013-2378
ER  - 

@article{
author = "Vučinić, Slavica and Zlatković, Milica and Antonijević, Biljana and Ćurčić, Marijana and Bošković, Bogdan",
year = "2013",
abstract = "Despite improvements to intensive care management and specific pharmacological treatments (atropine, oxime, diazepam), the mortality associated with organophosphate (OP) poisoning has not substantially decreased. The objective of this examination was to describe the role of fresh frozen plasma (FFP) in acute OP poisoning. After a deliberate ingestion of malathion, a 55-year-old male suffering from miosis, somnolence, bradycardia, muscular fasciculations, rales on auscultation, respiratory insufficiency, as well as from an inhibition of red blood cell acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BuChE), was admitted to hospital. Malathion was confirmed in a concentration of 18.01 mg L-1. Apart from supportive measures (including mechanical ventilation for four days), antidotal treatment with atropine, oxime - pralidoxime methylsulphate (Contrathion (R)), and diazepam was administered, along with FFP. The potentially beneficial effects of FFP therapy included a prompt increase of BuChE activity (from 926 IU L-1 to 3277 IU L-1; reference range from 7000 IU L-1 to 19000 IU L-1) and a reduction in the malathion concentration, followed by clinical recovery. Due to BuChE replacement, albumin content, and volume restitution, FFP treatment may be used as an alternative approach in patients with acute OP poisoning, especially when oximes are not available.",
publisher = "Inst Medical Research & Occupational Health, Zagreb",
journal = "Arhiv za higijenu rada i toksikologiju - Archives of Industrial Hygiene and Toxicology",
title = "Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning",
volume = "64",
number = "2",
pages = "273-277",
doi = "10.2478/10004-1254-64-2013-2378"
}

Vučinić, S., Zlatković, M., Antonijević, B., Ćurčić, M.,& Bošković, B.. (2013). Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning. in Arhiv za higijenu rada i toksikologiju - Archives of Industrial Hygiene and Toxicology
Inst Medical Research & Occupational Health, Zagreb., 64(2), 273-277.
https://doi.org/10.2478/10004-1254-64-2013-2378

Vučinić S, Zlatković M, Antonijević B, Ćurčić M, Bošković B. Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning. in Arhiv za higijenu rada i toksikologiju - Archives of Industrial Hygiene and Toxicology. 2013;64(2):273-277.
doi:10.2478/10004-1254-64-2013-2378 .

Vučinić, Slavica, Zlatković, Milica, Antonijević, Biljana, Ćurčić, Marijana, Bošković, Bogdan, "Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning" in Arhiv za higijenu rada i toksikologiju - Archives of Industrial Hygiene and Toxicology, 64, no. 2 (2013):273-277,
https://doi.org/10.2478/10004-1254-64-2013-2378 . .

TY  - JOUR
AU  - Vučinić, Slavica
AU  - Antonijević, Biljana
AU  - Ilić, Nela V.
AU  - Ilić, Tihomir V.
PY  - 2013
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2054
AB  - Introduction. Intermediate syndrome (IMS) was described a few decades ago, however, there is still a controversy regarding its exact etiology, risk factors, diagnostic parameters and required therapy. Considering that acute poisonings are treated in different types of medical institutions this serious complication of organophosphate insecticide (OPI) poisoning is frequently overlooked. The aim of this paper was to present a case of IMS in organophosphate poisoning, which, we believe, provides additional data on the use of oxime or atropine. Case report. After a well-resolved cholinergic crisis, the patient developed clinical presentation of IMS within the first 72 h from deliberate malathion ingestion. The signs of IMS were weakness of proximal limb muscles and muscles innervated by motor cranial nerves, followed by the weakness of respiratory muscles and serious respiratory insufficiency. Malathion and its active metabolite were confirmed by analytical procedure (liquid chromatography-mass spectrometry). Pralidoxime methylsulphate, adiministered as a continuous infusion until day 8 (total dose 38.4 g), and atropine until the day 10 (total dose 922 mg) did not prevent the development of IMS, hence the mechanical ventilation that was stopped after 27 h had to be continued until the day 10. Conclusion. Continuous pralidoxime methylsulphate infusion with atropine did not prevent the development of IMS, most likely due to the delayed treatment and insufficient oxime dose but also because of chemical structure and lipophilicity of ingested OPI. A prolonged intensive care monitoring and respiratory care are the key management for the intermediate syndrome.
AB  - Uvod. Intermedijerni sindrom (IMS) opisan je pre nekoliko decenija, međutim i dalje postoje kontroverze u vezi sa njegovom etiologijom, faktorima rizika, dijagnostičkim parametrima i potrebnom terapijom. S obzirom na to da se akutna trovanja leče u medicinskim ustanovama različitog tipa, ova teška komplikacija akutnih trovanja organofosfornim insekticidima (OFI) često se ne prepoznaje. Cilj rada bio je da se prikaže slučaj akutnog trovanja organofosfornim insekticidom koji će dati dodatne podatke o upotrebi oksima i atropina. Prikaz bolesnika. Nakon kupirane holinergičke krize kod bolesnika, 72 h od namerne ingestije malationa, došlo je do razvoja kliničke slike IMS. Znaci IMS su uključivali slabost mišića gornjih ekstremiteta i mišića inervisanih motornim kranijalnim nervima, što je bilo praćeno slabošću respiratorne muskulature i teškom respiratornom insuficijencijom. Malation i njegov aktivni metabolit potvrđeni su analitičkom procedurom (tečna hromatografijamasena spektrometrija). Kontinuiranom infuzijom pralidoksim metilsulfata do osmog dana (ukupno 38,4 g) i atropina do desetog dana (ukupna doza 922 mg), nije sprečen razvoj IMS, te je mehanička ventilacija, koja je prekinuta nakon 27 h, morala biti nastavljena do desetog dana. Zaključak. Kontinuiranom infuzijom pralidoksim-metilsulfata i atropina nije sprečen razvoj IMS, najverovatnije zbog odloženog početka lečenja i nedovoljne doze primenjenog oksima, ali i hemijske strukture i lipofilnosti ingestiranog OFI. Istaknut je značaj produžene opservacije u jedinici intenzivne nege i respiratorne podrške u lečenju intermedijernog sindroma.
PB  - Vojnomedicinska akademija - Institut za naučne informacije, Beograd
T2  - Vojnosanitetski pregled
T1  - Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning
T1  - Neuspeh sprečavanja razvoja intermedijernog sindroma kod akutnog trovanja organofosfornim insekticidima primenom oksima i atropina
VL  - 70
IS  - 4
SP  - 420
EP  - 423
DO  - 10.2298/VSP120229037V
ER  - 

@article{
author = "Vučinić, Slavica and Antonijević, Biljana and Ilić, Nela V. and Ilić, Tihomir V.",
year = "2013",
abstract = "Introduction. Intermediate syndrome (IMS) was described a few decades ago, however, there is still a controversy regarding its exact etiology, risk factors, diagnostic parameters and required therapy. Considering that acute poisonings are treated in different types of medical institutions this serious complication of organophosphate insecticide (OPI) poisoning is frequently overlooked. The aim of this paper was to present a case of IMS in organophosphate poisoning, which, we believe, provides additional data on the use of oxime or atropine. Case report. After a well-resolved cholinergic crisis, the patient developed clinical presentation of IMS within the first 72 h from deliberate malathion ingestion. The signs of IMS were weakness of proximal limb muscles and muscles innervated by motor cranial nerves, followed by the weakness of respiratory muscles and serious respiratory insufficiency. Malathion and its active metabolite were confirmed by analytical procedure (liquid chromatography-mass spectrometry). Pralidoxime methylsulphate, adiministered as a continuous infusion until day 8 (total dose 38.4 g), and atropine until the day 10 (total dose 922 mg) did not prevent the development of IMS, hence the mechanical ventilation that was stopped after 27 h had to be continued until the day 10. Conclusion. Continuous pralidoxime methylsulphate infusion with atropine did not prevent the development of IMS, most likely due to the delayed treatment and insufficient oxime dose but also because of chemical structure and lipophilicity of ingested OPI. A prolonged intensive care monitoring and respiratory care are the key management for the intermediate syndrome., Uvod. Intermedijerni sindrom (IMS) opisan je pre nekoliko decenija, međutim i dalje postoje kontroverze u vezi sa njegovom etiologijom, faktorima rizika, dijagnostičkim parametrima i potrebnom terapijom. S obzirom na to da se akutna trovanja leče u medicinskim ustanovama različitog tipa, ova teška komplikacija akutnih trovanja organofosfornim insekticidima (OFI) često se ne prepoznaje. Cilj rada bio je da se prikaže slučaj akutnog trovanja organofosfornim insekticidom koji će dati dodatne podatke o upotrebi oksima i atropina. Prikaz bolesnika. Nakon kupirane holinergičke krize kod bolesnika, 72 h od namerne ingestije malationa, došlo je do razvoja kliničke slike IMS. Znaci IMS su uključivali slabost mišića gornjih ekstremiteta i mišića inervisanih motornim kranijalnim nervima, što je bilo praćeno slabošću respiratorne muskulature i teškom respiratornom insuficijencijom. Malation i njegov aktivni metabolit potvrđeni su analitičkom procedurom (tečna hromatografijamasena spektrometrija). Kontinuiranom infuzijom pralidoksim metilsulfata do osmog dana (ukupno 38,4 g) i atropina do desetog dana (ukupna doza 922 mg), nije sprečen razvoj IMS, te je mehanička ventilacija, koja je prekinuta nakon 27 h, morala biti nastavljena do desetog dana. Zaključak. Kontinuiranom infuzijom pralidoksim-metilsulfata i atropina nije sprečen razvoj IMS, najverovatnije zbog odloženog početka lečenja i nedovoljne doze primenjenog oksima, ali i hemijske strukture i lipofilnosti ingestiranog OFI. Istaknut je značaj produžene opservacije u jedinici intenzivne nege i respiratorne podrške u lečenju intermedijernog sindroma.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning, Neuspeh sprečavanja razvoja intermedijernog sindroma kod akutnog trovanja organofosfornim insekticidima primenom oksima i atropina",
volume = "70",
number = "4",
pages = "420-423",
doi = "10.2298/VSP120229037V"
}

Vučinić, S., Antonijević, B., Ilić, N. V.,& Ilić, T. V.. (2013). Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning. in Vojnosanitetski pregled
Vojnomedicinska akademija - Institut za naučne informacije, Beograd., 70(4), 420-423.
https://doi.org/10.2298/VSP120229037V

Vučinić S, Antonijević B, Ilić NV, Ilić TV. Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning. in Vojnosanitetski pregled. 2013;70(4):420-423.
doi:10.2298/VSP120229037V .

Vučinić, Slavica, Antonijević, Biljana, Ilić, Nela V., Ilić, Tihomir V., "Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning" in Vojnosanitetski pregled, 70, no. 4 (2013):420-423,
https://doi.org/10.2298/VSP120229037V . .