1 / 13

P.M.S. Perera , A.H. Dawson, I.B. Gawarammana , S. Sayed

A prospective comparative cohort study on the dosing pattern of atropine in Organophosphorous and Carbamate poisoning in rural Sri lanka. P.M.S. Perera , A.H. Dawson, I.B. Gawarammana , S. Sayed South Asian Clinical Toxicology Research Collaboration Central Province Clinical Unit

marlee
Download Presentation

P.M.S. Perera , A.H. Dawson, I.B. Gawarammana , S. Sayed

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A prospective comparative cohort study on the dosing pattern of atropine in Organophosphorous and Carbamate poisoning in rural Sri lanka P.M.S. Perera, A.H. Dawson, I.B. Gawarammana, S. Sayed South Asian Clinical Toxicology Research Collaboration Central Province Clinical Unit Peradeniya General Hospital Sri Lanka

  2. Total Hospital Admissions and Deaths Due to Poisoning 2005in Sri-lanka Source: National Poison Center Sri-Lanka

  3. Atropine Dose in Organophosphates • Sri Lankan ventilated OP patients who survived require • Mean initial dose of 23.4 mgs. • Maximum initial dose of 75 mgs. • 38 texts with 31 different recommendations Eddleston et al .Speed of initial atropinisation in significant organophosphorus pesticide poisoning. J ToxClinTox2004;42(6):865-75

  4. Purpose of the study • To examine the safety and efficacy of atropine in a cohort of patients with acute cholinesterase inhibitor poisoning

  5. Methodology February to July 2006

  6. A t r o p i n i z a t i o n A t r o p i n e r e q u i r e m e n t 2 4 1 6 8 C l e a r l u n g s P o o r a i r e n t r y i n t o l u n g s c a u s e d b y b r o n c h o s p a s m a n d b r o n c h o r r h o e a 4 0 D r y a x i l l a e E x c e s s i v e s w e a t i n g 3 0 S y s t o l . B P > ( H y p o t e n s i o n ) 8 0 m m H g 2 0 H e a r t r a t e > ( B r a d y c a r d i a ) 8 0 / m i n N o m i o s i s 1 0 ( M i o s i s ) 0 0 5 1 0 1 5 m i n a f t e r f i r s t a t r o p i n e d o s e Scheme of atropinization (endpoints to be reached) • Eddleston M, Buckley NA, Mohamed F, Senarathna L, Hittarage A, Dissanayake W, Azhar S, Sheriff MHR, Dawson AH. Speed of initial atropinisation in significant organophosphorus pesticide poisoning - a comparison of recommended regimens. Journal of Toxicology – Clinical Toxicology 2004;6:865-875.

  7. Atropine Outcomes

  8. Summary of major outcomes of pesticides Data are number (%) £Diazinon, Phethoate, Acephate, Profenopos, Fenthion

  9. Conclusions • Titrated atropine dosing was associated with significantly less atropine toxicity • There is no difference in patient mortality • Atropine doses should be titrated against response and toxicity • The use of a structured monitoring sheet may assist in more appropriate atropine use

  10. Acknowledgments Wellcome Trust & NHMRC Prof Nick Buckley SACTRC Members Hospital Doctors Nurses and Patients

More Related