26/09/2023
OPC poisoning :-
What is Ageing?
In OPC poisoning, OPC binds with Acetylcholinesterase enzyme and forms the OPC-AChE complex.
What are the problems with this complex???
The problem is this complex loss of the Alkyl group.
So what? What is the outcome of alkyl group loss?
If this complex loss of the alkyl group,there is permanent inactivation of Acetylcholinesterase enzyme.
To better understand, you need to know the function of Acetylcholinesterase enzyme.
Acetylcholinesterase enzyme(AChE) breaks acetylcholine into choline and acetate, so, if there is no AchE, no breakdown of Acetylcholine.
So it produces Acetylcholine accumulation (excess) in the body,and produces signs and symptoms.
What are the clinical features of excess acetylcholine?
1 increased sweating,
2.increase lacrimation
3. Nausea, Vomiting
4.Abdominal cramps
5.Watery diarrhea
6.Involuntary defecation/urination.
7.Pupils are constricted.
Can you guess something? "
"What?"
Every clinical feature is parasympathetic, like signs and symptoms.
"Yeap,but why?"
Because Acetylcholine is a postsynaptic parasympathetic neurotransmitter.So,Acetylcholine excess and parasympathetic stimulated excess are the same things.
How can we prevent the ageing process?
Answer:Oxime ( pralidoxime), but remember you must use paliddoxime before the ageing process.
Dose of Pralidoxime: Pralidoxime 2gm IV over 4 mins.( repeated 4-6 hours later)..
What is the function of Oxime?
Answer :Oxime prevents the ageing process AchE, which is not yet the loss of the Alkyl group.
So, as early as possible, we should give pralidoxime.
Pralidoxime provides hypotension especially if administered rapidly..
Please do not kill the patient by giving pralidoxime so rapidly due to hypotension.
