Abstract
C compounds [acetylcholinesterase(AChE) inhibitors], are widely used pesticides. Their toxic effects are similar to organophosphate poisoning(OPP), but they are considered less toxic and without CNS effect; information on infants is limited. Oximes, the mainstay of OPP therapy are not recommended in C poisoning. During the years 89-92 we studied 26 children (1-8 yrs;med-26 mos) with severe C poisoning:methomyl (n=17) and aldicarb (n=9). All required PICU for severe CNS depression. All were flaccid and 80% had miosis. All were treated with atropine sulphate and obidoxime chloride and recovered within 24h. Since our observation contradicts animal studies that oximes enhance C cholinergic activity, we studied the effect of the oximes obidoxime chloride and pralidoxime on human red blood cells (RBC's) pretreated either with C (methomyl or aldicarb) or an OPP (paraoxone) by measuring AChE activity. AChE was depressed both by OPP and C. The addition of oximes reactivated AChE of RBC's pretreated with OPP, but had no effect on RBC' s pretreated with C. We conclude that in infants and children C poisoning resembles clinically that of OPP with mainly CNS effect. Oximes have no deleterious effect on C poisoning and AChE both in vivo and in vitro.
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Sofer, S., Lifshitz, M., Shahak, E. et al. 366 CARBAMATE (C) POISONING AND OXIME THERAPY. Pediatr Res 36, 63 (1994). https://doi.org/10.1203/00006450-199407000-00366
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DOI: https://doi.org/10.1203/00006450-199407000-00366
