Date of this Version
Reproduced with Permission by the DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE, From the Archives of Environmental Health, Vol. 5, pp. 21-47, July 1962 Copyright 1962, by American Medical Association.
Nature and Physiologic Function of Cholinesterase
Symptoms of Organic Phosphorus Poisoning
Mechanism of Inhibition of Cholinesterase
Measurement of Cholinesterase Activity and Its Relationship to Symptomatology
Measurement of Metabolites and Their Relationship to Symptomatology
Use and Action of Atropine and Other Nonspecific Antidotes
Development of Specific Antidotes
Chemical and Physiologic Properties of Oximes
Antidotal Efficacy of Oximes in Poisoned Experimental Animals
Application of 2-P AM in Poisoning in Man
Suggestions for Treatment
Prevention of Poisoning
Comment and Summary
Organic phosphorus compounds are of considerable interest and importance by virture of their widespread use as insecticides; their effectiveness in the treatment of myasthenia gravis, glaucoma, and abdominal distention; and their potential application as war gases. These compounds owe their pharmacologic effect primarily, if not entirely, to their ability to inhibit the enzyme cholinesterase with a resultant overstimulation of the parasympathetic nervous system by the acetylcholine which accumulates. Atropine has been the drug of choice for the treatment of organophosphorus poisoning. This therapy produces relief of symptoms based on blocking the action of excess acetylcholine.