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Old 08-08-2012
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Default a pediatric case for u

The parents of a 9-year-old girl bring their daughter to the emergency department For the last 12 hours, she has suffered severe nausea and vomiting, as well as diarrhea and abdominal cramps Further discussion with the child indicates that she suffers from blurred vision and headache. Her blood pressure is 88/48 mm Hg. pulse is 90/min. respirations are 33/min. and temperature is 38 C (100.3 F). She appears sweaty and confused Auscultation of the lungs reveals a diffuse wheeze. bilaterally Pupils measure 2 mm. and she has diffuse muscle weakness, absent deep tendon reflexes, and fasciculations Which of the following interventions is the most appropriate treatment for this child's condition,

A. Atropine
B. Botulism antitoxin
C. Dimercaprol
D. Plasmapheresis for Guillain-Barre syndrome
E. Pralidoxime
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Old 08-08-2012
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Answer E -Pralidoxime
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Old 08-08-2012
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Yea answer is correct ...This s a case of organophosphorous poisoning ..but Why not atropine ...usual antidote of organophosphorous...
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Old 08-08-2012
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Organophosphate poisoning results in nicotinic and muscarinic overstimulation

Muscarinc manifestations are visual disturbances, tightness in chest, wheezing due to bronchoconstriction, increased bronchial secretions, increased salivation, lacrimation, sweating, peristalsis, and urination

Nicotininc manifestations are muscle weakness,absent deep tendon reflexes ,fasiculations ,anxiety, headache, convulsions, ataxia, depression of respiration and circulation, tremor and potentially coma

Atropine will only reverse the muscarinic symptoms but not nicotinic .

so first line would be Pralidoxime which reactivates the acetylcholinesterase and addresses to both muscarinic and nicotinc symptoms and then eventually we will give atropine .

But first line would be pralidoxime for organophosphate poisoning.
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Old 08-08-2012
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Which antidote for malathion intoxication?
Quite similar question.
Normally atropine + pralidoxime is used together. As atropine is muscarinic antagonist where as pralidoxime regenerates AchE.


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