Abstract

This is a case report focusing on a 34 year male patient who allegedly consumed pesticides for suicidal intention. The aim of the study is to determine the clinical presentation and outcome of acute organophosphorus poisoning.  Organophosphates are the most common and wide spread mode of poisoning in Asia resulting in high mortality rate. Organophosphate compounds are irreversible cholinesterase inhibitors which inhibits both cholinesterase (ChE) and pseudo cholinesterase activity. The inhibition of cholinesterase activity leads to accumulation of acetylcholine at synapses, causing overstimulation and disruption of neurotransmission in central nervous system. The patient was reported in unconscious and unarousable state with lethargy, jerky respiration and excessive secretions from mouth. On examination he had pin-point dilated pupils reacting to light, generalized hypotonia, absent deep tendon reflexes.The patient recovered after requiring almost 1 mg/kg of atropine, 2 gms of Pralidoxime and ventilatory support for 6 days. The overview of organophosphate poisoning and its management is given.  The two important aspects of the management are vigilance of the atropine drip, especially at night, and other physical and psychological support has given to the patient. Clinical pharmacist team has done the psycho-social assessment by: finding out the reason of consumption, letting the patients vent their feelings and discussing with them different aspects of their situations giving them different paradigms. This is the first report of Organophosphates Poisoning complicated by Intermediate Syndrome and it is reported to increase awareness of health care professionslas on these rare complications of a common problem.