Organophosphate insecticide poisoning

Pharmacology

One of the effects of organophosphate poisoning is inhibition of acetylcholinesterase

Features can be predicted by the accumulation of acetylcholine (mnemonic = SLUD)

Salivation
Lacrimation
Urination
Defecation/diarrhoea
cardiovascular: hypotension, bradycardia
also: small pupils, muscle fasciculation

Management

atropine
the role of pralidoxime is still unclear - meta-analyses to date have failed to show any clear benefit