Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning
Апстракт
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 in...crease 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.
Кључне речи:
acetylcholinesterases / albumin / butyrylcholinesterase / malathion / oximesИзвор:
Arhiv za higijenu rada i toksikologiju - Archives of Industrial Hygiene and Toxicology, 2013, 64, 2, 273-277Издавач:
- Inst Medical Research & Occupational Health, Zagreb
Финансирање / пројекти:
- Геолошка и екотоксиколошка истраживања у идентификацији геопатогених зона токсичних елемената у акумулацијама воде за пиће - истраживање метода и поступака смањивања утицаја биогеохемијских аномалија (RS-MESTD-Basic Research (BR or ON)-176018)
DOI: 10.2478/10004-1254-64-2013-2378
ISSN: 0004-1254
PubMed: 23819936
WoS: 000321168600010
Scopus: 2-s2.0-84881119418
Институција/група
PharmacyTY - 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 . .