26 - Clinical features of Organophosphorous poisoning

*Since organophosphorous compounds are powerful inhibitors of cholinesterase, their poisoning manifests as cholinergic symptoms.

*The clinical features of Organophosphorous poisoning are :

A. MUSCARINIC ACTIONS :
1. Bronchoconstriction and increased bronchial secretion - simulates bronchial asthma. Other symptoms are dyspnea, cough, pulmonary edema and cyanosis.
2. Increased sweating
3. Increased salivation
4. Increased lacrimation - tears may be red
5. Slightly bradycardia
6. Miosis, Blurring/Dimness of vision
7. Increased frequency of micturition and involuntary micturition.
8. Abdominal cramps, diarrhea, epigastric/substernal tightness

B.NICOTINIC ACTIONS :
1. On striated muscles - easy fatigue, fasciculations, cramps, dyspnea (weakness of respiratory muscles and cyanosis)
2. On sympathetic ganglia - Pallor, Occasional elevation of B.P

C. CNS ACTIONS :
1. Restlessness, irritability, apprehension
2. Fine fibrillary tremors of hands, eye lids, tongue
3. Mental confusion, convulsions
4. Coma with absence of reflexes and depression of respiratory and circulatory centres. Death usually occurs due to paralysis of respiratory muscles.

Parikh' Textbook of Medical Jurisprudence Forensic Medicine and Toxicology