Report of a case of suicide with Organophosphorus poisons

Introduction:Organophosphorus compounds are cholinesterase inhibitors that are widely used as pesticides in agriculture and nerve agents in battlefields. Exposure to these compounds through inhibiting the enzyme acetylcholinesterase leads to accumulation of acetylcholine in cholinergic synapses and excessive stimulation of nicotinic and muscarinic receptors. In poisoning with these toxins, four clinical syndromes of cholinergic crisis, interstitial syndrome, delayed neuropathy and chronic neuropsychiatric disorder have been defined. On the other hand, each of these syndromes has its own symptoms.Purpose:The aim of this study was report of a case of suicide with Organophosphorus poisons.introduction:A ۲۵-year-old lady with symptoms of garlic smell in the respiratory system, sweating, increased salivation, bradycardia, increased blood pressure, fever, miosis and respiratory distress went to the emergency room, and after taking a history from the patient's companions, it was determined that she had diazinon poisoning. used with the intention of committing suicide. The patient's contaminated clothes were immediately removed and the stomach was washed. A test to measure cholinesterase in whole blood and serum and VBG was requested. The amount of cholinesterase in whole blood was ۵ and in serum was ۳۰۰۰. Blood pH was ۷.۳۵, and sodium bicarbonate was injected intravenously to resolve metabolic acidosis. To relieve the symptoms of poisoning, ۱ mg of atropine was injected to the patient every ۵ minutes. ۳۰ mg of diazepam was injected intramuscularly to prevent seizures. To control tachycardia and ventricular arrhythmias, magnesium sulfate was administered at a dose of ۴ grams daily. The patient was injected intravenously. Finally, after the partial improvement of the clinical condition, the patient was referred for psychiatric consultation.Discussion and conclusion:Traditional and standard treatment in organophosphate poisoning will include supportive treatment, detoxification and treatment with atropine sulfate antidote alone or with an oxime. Some other drugs such as Glycopyrrolate, Sodium bicarbonate and Magnesium sulfate may also be used in some cases. But there are still many unanswered questions in the treatment of Organophosphorus poisoning.

کلیدواژه ها:

Suicide ، Organophosphorus ، poisons