Atropine maintenance dosage in patients with severe organophosphate pesticide poisoning

Toxicology Letters

Volumn 206, Issue 1, 2011, Pages 77-83

  Thiermann, Horst ^a   Steinritz, Dirk ^a   Worek, Franz ^a   Radtke, Maria ^b   Eyer, Peter ^b   Eyer, Florian ^c   Felgenhauer, Norbert ^c   Zilker, Thomas ^c  

^a BUNDESWEHR INSTITUTE OF PHARMACOLOGY AND TOXICOLOGY   (Germany)

^b UNIVERSITY OF MUNICH   (Germany)

^c TECHNICAL UNIVERSITY OF MUNICH   (Germany)

Author keywords

Acetylcholinesterase; Atropine; Dysrhythmia; Human; Organophosphorus pesticide; Pharmacokinetics; Poisoning

Indexed keywords

AMIODARONE; ATROPINE; HYOSCYAMINE; OBIDOXIME; ORGANOPHOSPHATE PESTICIDE;

ADULT; AGED; AREA UNDER THE CURVE; ARTICLE; ARTIFICIAL VENTILATION; BRADYCARDIA; CARDIOVASCULAR FUNCTION; CLINICAL ARTICLE; CLINICAL EFFECTIVENESS; DISEASE SEVERITY; DRUG BLOOD LEVEL; DRUG DOSE REDUCTION; DRUG ELIMINATION; DRUG HALF LIFE; EMERGENCY CARE; ENANTIOMER; ENZYME ACTIVITY; ENZYME INHIBITION; FEMALE; HEART VENTRICLE EXTRASYSTOLE; HUMAN; HYPERSALIVATION; INTENSIVE CARE; INTOXICATION; MALE; MIOSIS; NEUROMUSCULAR DISEASE; NEUROMUSCULAR TRANSMISSION; PHARMACOKINETICS; PHYSICIAN; PRIORITY JOURNAL; QT PROLONGATION; RADIORECEPTOR ASSAY; RETROSPECTIVE STUDY; SUICIDE ATTEMPT;

ACETYLCHOLINESTERASE; AGED; AREA UNDER CURVE; ATROPINE; CLINICAL TRIALS AS TOPIC; DOSE-RESPONSE RELATIONSHIP, DRUG; ERYTHROCYTES; FEMALE; HUMANS; MALE; MIDDLE AGED; MUSCARINIC ANTAGONISTS; PESTICIDES; PHOSPHORIC ACID ESTERS; POISONING; RETROSPECTIVE STUDIES; STEREOISOMERISM; SUICIDE, ATTEMPTED; TREATMENT OUTCOME;

EID: 80051813965     PISSN: 03784274     EISSN: 18793169     Source Type: Journal    
DOI: 10.1016/j.toxlet.2011.07.006     Document Type: Article

References (69)

1. Aaltonen L., Kanto J., Iisalo E., Pihlajamaki K. Comparison of radioreceptor assay and radioimmunoassay for atropine: pharmacokinetic application. Eur. J. Clin. Pharmacol. 1984, 26:613-617.
2. Aardema H., Meertens J.H., Ligtenberg J.J., Peters-Polman O.M., Tulleken J.E., Zijlstra J.G. Organophosphorus pesticide poisoning: cases and developments. Neth. J. Med. 2008, 66(4):149-153.
3. Adams R.G., Verma P., Jackson A.J., Miller R.L. Plasma pharmacokinetics of intravenously administered atropine in normal human subjects. J. Clin. Pharmacol. 1982, 22:477-481.
4. Ali-Melkkila T., Kanto J., Iisalo E. Pharmacokinetics and related pharmacodynamics of anticholinergic drugs. Acta Anaesthesiol. Scand. 1993, 37:633-642.
5. Arendse R., Irusen E. An atropine and glycopyrrolate combination reduces mortality in organophosphate poisoning. Hum. Exp. Toxicol. 2009, 28(11):715-720.
6. Aurbek N., Thiermann H., Eyer F., Eyer P., Worek F. Suitability of human butyrylcholinesterase as therapeutic marker and pseudo catalytic scavenger in organophosphate poisoning: a kinetic analysis. Toxicology 2009, 259(3):133-139.
7. Avasthi G., Singh G. Serial neuro-electrophysiological studies in acute organophosphate poisoning - correlation with clinical findings, serum cholinesterase levels and atropine dosages. J Assoc. Physicians India 2000, 48:794-799.
8. Balali-Mood M., Shariat M. Treatment of organophosphate poisoning. Experience of nerve agents and acute pesticide poisoning on the effects of oximes. J. Physiol. Paris 1998, 92:375-378.
9. Bar-Meir E., Schein O., Eisenkraft A., Rubinshtein R., Grubstein A., Militianu A., Glikson M. Guidelines for treating cardiac manifestations of organophosphates poisoning with special emphasis on long QT and Torsades De Pointes. Crit. Rev. Toxicol. 2007, 37(3):279-285.
10. Beards S.C., Kraus P., Lipman J. Paralytic ileus as a complication of atropine therapy following severe organophosphate poisoning. Anaesthesia 1994, 49:791-793.
11. Brank M., Zajc-Kreft K., Kreft S., Komel R., Grubic Z. Biogenesis of acetylcholinesterase is impaired, although its mRNA level remains normal, in the glucocorticoid-treated rat skeletal muscle. Eur. J. Biochem. 1998, 251(1-2):374-381.
12. Buckley N.A., Eddleston M., Li Y., Bevan M., Robertson J. Oximes for acute organophosphate pesticide poisoning. Cochrane Database Syst. Rev. 2011, 2. CD005085.
13. de Silva H.J., Wijewickrema R., Senanayake N. Does pralidoxime affect outcome of management in acute organophosphorus poisoning?. Lancet 1992, 339:1136-1138.
14. Doorn J.A., Thompson C.M., Christner R.B., Richardson R.J. Stereoselective inactivation of Torpedo californica acetylcholinesterase by isomalathion: inhibitory reactions with (1R)- and (1S)-isomers proceed by different mechanisms. Chem. Res. Toxicol. 2003, 16(8):958-965.
15. DuToit P.W., Müller F.O., VanTonder W.M., Ungerer M.J. Experience with the intensive care management of organophosphate insecticide poisoning. S. Afr. Med. J. 1981, 60:227-229.
16. Eddleston M., Buckley N.A., Checketts H., Senarathna L., Mohamed F., Sheriff M.H., Dawson A. Speed of initial atropinisation in significant organophosphorus pesticide poisoning - a systematic comparison of recommended regimens. J. Toxicol. Clin. Toxicol. 2004, 42(6):865-875.
17. Eddleston M., Buckley N.A., Eyer P., Dawson A.H. Management of acute organophosphorus pesticide poisoning. Lancet 2008, 371(9612):597-607.
18. Eddleston M., Eyer P., Worek F., Mohamed F., Senarathna L., von M.L., Juszczak E., Hittarage A., Azhar S., Dissanayake W., Sheriff M.H., Szinicz L., Dawson A.H., Buckley N.A. Differences between organophosphorus insecticides in human self-poisoning: a prospective cohort study. Lancet 2005, 366(9495):1452-1459.
19. Eddleston M., Mohamed F., Davies J.O., Eyer P., Worek F., Sheriff M.H., Buckley N.A. Respiratory failure in acute organophosphorus pesticide self-poisoning. QJM 2006, 99(8):513-522.
20. Ensing K., de Zeeuw R.A., Hornchen U., Schuttler J., Stoeckel H. Determination of atropine in plasma by a direct radioreceptor assay. Pharm. Weekbl. Sci. 1987, 9:321-323.
21. Eyer F., Meischner V., Kiderlen D., Thiermann H., Worek F., Haberkorn M., Felgenhauer N., Zilker T., Eyer P. Human parathion poisoning. Toxicol. Rev. 2003, 22(3):143-163.
22. Eyer F., Worek F., Eyer P., Felgenhauer N., Haberkorn M., Zilker T., Thiermann H. Obidoxime in acute organophosphate poisoning: 1 - clinical effectiveness. Clin. Toxicol. (Phila.) 2009, 47(8):798-806.
23. Eyer P. The role of oximes in the management of organophosphorus pesticide poisoning. Toxicol. Rev. 2003, 22:165-190.
24. Finkelstein Y., Kushnir A., Raikhlin-Eisenkraft B., Taitelman U. Antidotal therapy of severe acute organophosphate poisoning: a multihospital study. Neurotoxicol. Teratol. 1989, 11:593-596.
25. Furushima H., Niwano S., Chinushi M., Yamaura M., Taneda K., Washizuka T., Aizawa Y. Effect of atropine on QT prolongation and torsade de pointes induced by intracoronary acetylcholine in the long QT syndrome. Am. J. Cardiol. 1999, 83(5):714-718.
26. Golsousidis H., Kokkas V. Use of 19,590mg of atropine during 24 days of treatment, after a case of unusually severe parathion poisoning. Hum. Toxicol. 1985, 4(3):339-340.
27. Goswamy R., Chaudhuri A., Mahashur A.A. Study of respiratory failure in organophosphate and carbamate poisoning. Heart Lung 1994, 23:466-472.
28. Grob D. The manifestations and treatment of poisoning due to nerve gas and other organic phosphate anticholinesterase compounds. Arch. Intern. Med. 1956, 98:221-239.
29. Grubic Z., Sketelj J., Klinar B., Brzin M. Recovery of acetylcholinesterase in the diaphragm, brain, and plasma of the rat after irreversible inhibition by soman: a study of cytochemical localization and molecular forms of the enzyme in the motor end plate. J. Neurochem. 1981, 37:909-916.
30. Heath J.W.A., Meredith T. Atropine in the management of anticholinesterase poisoning. Clinical and Experimental Toxicology of Organophosphates Carbamates 1992, 543-554. Butterworth-Heinemann, Oxford. B. Ballantyne, C.T. Marrs, W.N. Aldridge (Eds.).
31. Heffron P.F., Hobbiger F. Relationship between inhibition of acetylcholinesterase and response of the rat phrenic nerve-diaphragm preparation to indirect stimulation at higher frequencies. Br. J. Pharmacol. 1979, 66:323-329.
32. Husain K., Ansari R.A., Ferder L. Pharmacological agents in the prophylaxis/treatment of organophosphorous pesticide intoxication. Indian J. Exp. Biol. 2010, 48(7):642-650.
33. John H., Eyer F., Zilker T., Thiermann H. High-performance liquid-chromatographic tandem-mass spectrometric methods for atropinesterase-mediated enantioselective and chiral determination of R- and S-hyoscyamine in plasma. Anal. Chim. Acta 2010, 680(1-2):32-40.
34. Johnson K.M., Vale J.A. Clinical management of acute organophosphate poisoning: an overview. Clinical and Experimental Toxicology of Organophosphates and Carbamates 1992, 528-535. Butterworth-Heinemann, Oxford. B. Ballantyne, C.T. Marrs, W.N. Aldridge (Eds.).
35. Kaila T., Korte J.M., Saari K.M. Systemic bioavailability of ocularly applied 1% atropine eyedrops. Acta Ophthalmol. Scand. 1999, 77(2):193-196.
36. Kalser S.C., McLain P.L. Atropine metabolism in man. Clin. Pharmacol. Ther. 1970, 11:214-227.
37. Karalliedde L., Szinicz L. Management of organophosphorus compound poisoning. Organophosphates and Health 2001, Imperial College Press, London, p. 257. L. Karalliedde, S. Feldman, J. Henry, C.T. Marrs (Eds.).
38. Kentala E., Kaila T., Iisalo E., Kanto J. Intramuscular atropine in healthy volunteers: a pharmacokinetic and pharmacodynamic study. Int. J Clin. Pharmacol. Ther. Toxicol. 1990, 28:399-404.
39. Kentala E., Kaila T., Kanto J. Intramuscular atropine in elderly people: pharmacokinetic studies using the radioreceptor assay and some pharmacodynamic responses. Pharmacol. Toxicol. 1989, 65:110-113.
40. Khan S., Hemalatha R., Jeyaseelan L., Oommen A., Zachariah A. Neuroparalysis and oxime efficacy in organophosphate poisoning: a study of butyrylcholinesterase. Hum. Exp. Toxicol. 2001, 20:169-174.
41. Kiss Z., Fazekas T. Organophosphates and torsade de pointes ventricular tachycardia [letter]. J. R. Soc. Med. 1983, 76:984-985.
42. LeBlanc F.N., Benson B.E., Gilg A.D. A severe organophosphate poisoning requiring the use of an atropine drip. J. Toxicol. Clin. Toxicol. 1986, 24(1):69-76.
43. Lee P., Tai D.Y. Clinical features of patients with acute organophosphate poisoning requiring intensive care. Intensive Care Med. 2001, 27:694-699.
44. Ludomirsky A., Klein H.O., Sarelli P., Becker B., Hoffman S., Taitelman U., Barzilai J., Lang R., David D., DiSegni E., Kaplinsky E. Q-T prolongation and polymorphous (torsade de pointes) ventricular arrhythmias ssociated with organophosphorus insecticide poisoning. Am. J. Cardiol. 1982, 49:1654-1658.
45. Miller L. The terrorist mind: I. A psychological and political analysis. Int. J. Offender. Ther. Comp. Criminol. 2006, 50(2):121-138.
46. Okumura T., Takasu N., Ishimatsu S., Miyanoki S., Mitsuhashi A., Kumada K., Tanaka K., Hinohara S. Report on 640 victims of the Tokyo subway sarin attack. Ann. Emerg. Med. 1996, 28:129-135.
47. Robenshtok E., Luria S., Tashma Z., Hourvitz A. Adverse reaction to atropine and the treatment of organophosphate intoxication. Isr. Med. Assoc. J. 2002, 4(7):535-539.
48. Singh G., Sidhu U.P., Mahajan R., Avasthi G., Whig J. Phrenic nerve conduction studies in acute organophosphate poisoning. Muscle Nerve 2000, 23(April (4)):627-632.
49. Singh S., Batra Y.K., Singh S.M., Wig N., Sharma B.K. Is atropine alone sufficient in acute severe organophosphorous poisoning?: experience of a North West Indian Hospital. Int. J. Clin. Pharmacol. Ther. 1995, 33(11):628-630.
50. Singh S., Chaudhry D., Behera D., Gupta D., Jindal S.K. Aggressive atropinisation and continuous pralidoxime (2-PAM) infusion in patients with severe organophosphate poisoning: experience of a northwest Indian hospital. Hum. Exp. Toxicol. 2001, 20(1):15-18.
51. Sohns T. Schutz vor B-Waffen in den Händen von Terroristen 1. Europäische Sicherheit 2000, 5:27-29.
52. Soreq H., Seidman S. Acetylcholinesterase - new roles for an old actor. Nat. Rev. Neurosci. 2001, 2(4):294-302.
53. Sungur M., Guven M. Intensive care management of organophosphate insecticide poisoning. Crit. Care 2001, 5(August (4)):211-215.
54. Tafuri J., Roberts J. Organophosphate poisoning. Ann. Emerg. Med. 1987, 16:193-202.
55. Thiermann H., Mast U., Klimmek R., Eyer P., Hibler A., Pfab R., Felgenhauer N., Zilker T. Cholinesterase status, pharmacokinetics and laboratory findings during obidoxime therapy in organophosphate poisoned patients. Hum. Exp. Toxicol. 1997, 16:473-480.
56. Thiermann H., Radtke M., Spöhrer U., Klimmek R., Eyer P. Pharmacokinetics of atropine in dogs after i.m. injection with newly developed dry/wet combination autoinjectors containing HI 6 or HLö 7. Arch. Toxicol. 1996, 70(5):293-299.
57. Thiermann H., Szinicz L., Eyer F., Worek F., Eyer P., Felgenhauer N., Zilker T. Modern strategies in therapy of organophosphate poisoning. Toxicol. Lett. 1999, 107:233-239.
58. Thiermann H., Szinicz L., Eyer P., Felgenhauer N., Zilker T., Worek F. Lessons to be learnt from organophosphorus pesticide poisoning for the treatment of nerve agent poisoning. Toxicology 2007, 233(1-3):145-154.
59. Thiermann H., Szinicz L., Eyer P., Zilker T., Worek F. Correlation between red blood cell acetylcholinesterase activity and neuromuscular transmission in organophosphate poisoning. Chem. Biol. Interact. 2005, 157-158:345-347.
60. Thiermann H., Worek F., Eyer P., Eyer F., Felgenhauer N., Zilker T. Obidoxime in acute organophosphate poisoning: 2 - PK/PD relationships. Clin. Toxicol. (Phila.) 2009, 47(8):807-813.
61. Tu A. The first mass chemical terrorism using sarin in Matsumoto, Japan. Arch. Toxicol. Kinet. Xenobiotic Metab. 2001, 9(3):65-93.
62. Voicu V.A., Thiermann H., Radulescu F.S., Mircioiu C., Miron D.S. The toxicokinetics and toxicodynamics of organophosphonates versus the pharmacokinetics and pharmacodynamics of oxime antidotes: biological consequences. Basic Clin. Pharmacol. Toxicol. 2010, 106(2):73-85.
63. Voicu V., Olinescu R. Enzymatic Mechanisms in Pharmacodynamics 1997, Abacus Press, Tunbridge Wells, p. 107.
64. Wellstein A., Pitschner H.F. Complex dose-response curves of atropine in man explained by different functions of M1- and M2-cholinoceptors. Naunyn Schmiedebergs Arch. Pharmacol. 1988, 338:19-27.
65. Willems J.L., De Bisschop H.C., Verstraete A.G., Declerck C., Christiaens Y., Vanscheeuwyck P., Buylaert W.A., Vogelaers D., Colardyn F. Cholinesterase reactivation in organophosphorus poisoned patients depends on the plasma concentrations of the oxime pralidoxime methylsulphate and of the organophosphate. Arch. Toxicol. 1993, 67:79-84.
66. Willems J. Poisoning by organophosphate insecticide: analysis af 53 human cases with regard to management and drug treatment. Acta Med. Milit. Belg. 1981, 134:7-14.
67. Worek F., Baecker M., Thiermann H., Szinicz L., Mast U., Klimmek R., Eyer P. Reappraisal of indications and limitations of oxime therapy in organophosphate poisoning. Hum. Exp. Toxicol. 1997, 16:466-472.
68. Worek F., Baumann M., Pfeiffer B., Aurbek N., Thiermann H. Mobile cholinesterase assay for the field diagnosis of organophosphate exposure in whole blood. Wehrmed. Mschr. 2011, 55:81-83.
69. Worek F., Mast U., Kiderlen D., Diepold C., Eyer P. Improved determination of acetylcholinesterase activity in human whole blood. Clin. Chim. Acta 1999, 288:73-90.