(eg, malthion, diazinon, parathion and "nerve gas")

(Med Let 1995;37:43)

Pathophys:Acetylcholinesterase inhibitors

Sx:H/o pesticide acute exposure

Si:Increased bronchial nasopharyngeal and gi secretions, muscle twitching and weakness, seizures, garlic breath (r/o arsenic)

Rx:

Atropine 2-6 mg iv/im, then more q 5 min until secretions decrease, may take 15-20+ mg

Pralidoxime HCl 1 gm iv over 15-30 min, may repeat × 1 in 1 h, or iv infusion of 500 mg/h

Diazepam 5-10 mg iv if seizures likely