Template:Cholinergic Toxicity Treatment: Difference between revisions
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#*Displaces an organophosphate from acetylcholinesterase (if given early) | #*Displaces an organophosphate from acetylcholinesterase (if given early) | ||
#*Dosing | #*Dosing | ||
##Adult: 1-2gm IV over 5-10min; continuous infusion of 500mg/hr if no initial response | ##Adult: 1-2gm IV over 5-10min; continuous infusion of 500mg/hr if no initial response | ||
##Child: 20-40mg/kg (up to 1gm) IV over 5-10min; 5-10mg/kg/hr if no initial response | ##Child: 20-40mg/kg (up to 1gm) IV over 5-10min; 5-10mg/kg/hr if no initial response | ||
Revision as of 12:29, 21 June 2015
Protection
- Wear protective clothing to prevent secondary poisoning
- Use neoprene or nitrile gloves (not latex)
Decontamination
- Dispose of all clothes
- Wash patient with soap and water
Airway
- Suction as needed
- Intubation often needed due to significant respiratory secretions / bronchospasm
- Use nondepolarizing agent (Rocuronium or Vecuronium)
Breathing
- Use O2 100% NRB
Antidotes
- Atropine
- May require massive dosage (hundreds of milligrams)
- Does not reverse muscle weakness due to nicotinic binding
- Dosing
- Adult: 1mg or more IV; repeat q5min until tracheobronchial secretions attenuate
- Child: 0.01-0.04mg/kg (but never <0.1mg) IV
- Pralidoxime
- For Organophosphate poisoning only.
- Has no use in Nicotinic poisoning
- Displaces an organophosphate from acetylcholinesterase (if given early)
- Dosing
- Adult: 1-2gm IV over 5-10min; continuous infusion of 500mg/hr if no initial response
- Child: 20-40mg/kg (up to 1gm) IV over 5-10min; 5-10mg/kg/hr if no initial response