Organophosphates

Excerpt

Organophosphates are chemical compounds formed through the esterification process involving phosphoric acid and alcohol. These chemicals serve as primary components in herbicides, pesticides, and insecticides and have extensive application in manufacturing plastics and solvents. Organophosphates can undergo hydrolysis and release alcohol from the ester bond. Organophosphates are also the primary constituents of nerve gas. Within the human body, organophosphates act as inhibitors of the enzyme acetylcholinesterase (AChE), leading to excess neurotransmitter acetylcholine (ACh). This surplus of ACh in the body leads to the manifestation of symptoms associated with the cholinergic toxidrome. Exposure to organophosphates, whether acute or chronic, can lead to varying degrees of toxicity in humans, animals, plants, and insects.

Clinical manifestations of toxicity include altered mental status, miosis, lacrimation, salivation, emesis, diarrhea, urinary incontinence, diaphoresis, muscle fasciculations, and weakness. Fatalities result from respiratory failure, often accompanied by bradycardia, bronchorrhea, and bronchospasm. Initial treatment of organophosphate toxicity involves accurately identifying the toxidrome and administering an appropriate antidote, such as atropine—a muscarinic antagonist. Although pralidoxime remains a subject of debate, it is recommended to prevent the aging process, where the bond between the organophosphate and AChE becomes irreversible. However, pralidoxime's effectiveness is time-sensitive and depends on the specific organophosphate.