Therapeutic Effect of Adding Magnesium Sulfate in Treatment of Organophosphorus Poisoning

Authors

  • Fatemeh Jamshidi Department of Emergency Medicine, Arak University of Medical Sciences, Arak
  • Arash Yazdanbakhsh Department of Emergency Medicine, Arak University of Medical Sciences, Arak
  • Mohammad Jamalian Arak University of Medical Sciences, Arak
  • Peyman Khademhosseini Department of Emergency Medicine, Karaj University of Medical Sciences, Alborz
  • Koroosh Ahmadi Department of Emergency Medicine, Karaj University of Medical Sciences, Alborz
  • Alireza Sistani Department of Emergency Medicine, Arak University of Medical Sciences, Arak
  • Abolfazl Jokar Department of Emergency Medicine, Arak University of Medical Sciences, Arak

DOI:

https://doi.org/10.3889/oamjms.2018.350

Keywords:

Magnesium sulfate, Poisoning, Organophosphorus

Abstract

BACKGROUND: In recent years, the prevalence of poisoning has increased dramatically due to population growth and access to drugs and toxins. Today poisoning is one of the important reasons for visiting hospitals.

AIM: The present study aimed to investigate the effect of magnesium sulfate on organophosphorous toxicity.

METHODS: Patients who had inclusion criteria in the study were randomly assigned to one of two groups (control group or case group) by an emergency medicine specialist. Patients' data including age, sex, ECG, vital signs, arterial oxygen saturation were recorded for patients. Patients in the case group (40 subjects) received 2 mg magnesium sulfate 50%, while the control group (40 subjects) received 100 cc normal saline (as placebo) as an intravenous infusion

RESULTS: The distribution of gender in the two groups of patients was the same. Also, the mean age, Stature and weight of patients were similar in both groups. In the group receiving magnesium sulfate, diastolic blood pressure was lower when compared with another group, at 0 and 2 hours after intervention. Moreover, the mean of systolic blood pressure in both groups was determined to be the same at all hours. Furthermore, the heart rate in the group receiving sulfate was lower as compared to the control group for 8 hours, 16 and 24 hours after intervention.

CONCLUSION: The use of magnesium sulfate in organophosphate poisoning reduces therapeutic costs an average hospital length of stay and mortality compared to those who did not receive magnesium sulfate.

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References

Moghaddamnia AA. Survey of acute suicidal poisoning in the west of Mazandaran province during the years 1994-97. J Mazandaran Univ Medical Sciences. 1999; 9(22-23):18-25.

Abdollahi M, Jalali N, Sabzevari O, Hoseini R, Ghanea T. A retrospective study of poisoning in Tehran. J Toxicol Clin Toxicol. 1997; 35:387-93. https://doi.org/10.3109/15563659709043371 PMid:9204099

Marx J, Walls R, Hockberger R. Rosen's Emergency Medicine-Concepts and Clinical Practice E-Book. Elsevier Health Sciences, 2013.

Paudyal BP. Poisoning: pattern and profile of admitted cases in a hospital in central Nepal. J Nepal Med Assoc. 2005; 44(159):6-92.

Moghadamnia AA, Abdollahi M. An epidemiological study of poisoning in northern Islamic Republic of Iran. East Mediterr Health J. 2002;8(1):88-94. PMid:15330564

Yaraghi A, Izadi Mood N, Gheshlaghi F, Rezvan M, Pazooki S. Evaluation of rodenticide poisoning distribution based on demographic characteristics, poisons, causes of intoxication, duration of hospitalization and mortality rate. Iranian J Toxicol. 2007; 2(1):100-4.

Ghorashi Z, Sultani Ahari H. A Study of the acute poisoning in patients admitted to Tabriz pediatrics medical center. J Ardabil Univ Med Sci Health Serv. 2003; 3(9):59-64.

Kanchan T, Menezes RG. Suicidal poisoning in Southern India: gender differences. J Forensic Leg Med. 2008; 15(1):7-14. https://doi.org/10.1016/j.jflm.2007.05.006 PMid:18096509

Rahimi R, Nikfar S, Abdollahi M. Increased morbidity and mortality in acute human organophosphate- poisoned patients treated by oximes: a meta- analysis of clinical trials. Hum Exp Toxicol. 2006; 25(3):157-62. https://doi.org/10.1191/0960327106ht602oa PMid:16634335

Dehghani R, Moosavi SG, Esalmi H, Mohammadi M,Jalali Z,Zamini N.Surveying of Pesticides Commonly on the Markets of Iran in 2009 .Journal of Environmental Protection. 2011; 2:1113-1117. https://doi.org/10.4236/jep.2011.28129

Katz K, Brooks D. Toxicity organophosphate. Available from: http://emedicine. Medscape. com/ article/ 167726-overview.

Cynthia K. Organophosphates and carbamate. Ford M, Delaney K, Ling L, Erickson T. Clinical toxicology, 2001: 819-29.

Verhulst L, Waggie Z, Reynold L, Hatherill M, Argent A. presentation and outcome of sever anticholinesterase insecticide poisoning. Archives of Disease in childhood. 2002; 86:352-55. https://doi.org/10.1136/adc.86.5.352 PMid:11970930 PMCid:PMC1751109

Grenvik A, Ayzes SM, Hoebrook PR, Shoemaker WC. Text book of critical care. 4th ed. Philadelphia, Pennsylvania: W.B Saunders company, 2000: 2074-5

Sharafi E. A survey in death due to poisoning in poisoning emergency dep. In Noor hospital in isfahan 1378 – 1380. Doctora Thesis, 1382, Isfahan university of medical sciences [Persian].

Culture Iranian generic drugs, doctor heshmati, 2008.

Abdollahi M, Jafari A, Jalali N, Balai MM, Kebriaeeza-deh A, Nikfar S. A new approach to the efficacy of oximes in the management of acute organophosphate poisoning. Irn JMed Sci. 1995; 20:105-109.

Cherian AM, Peter JV, Samuel J, Jaydevan R, Peter S,Joel S et al. Effectiveness of pralidoxime in thetreatment of organophosphorus poisoning: a rando-mized, double blind placebo controlled clinical trial. J Assoc Physicians India. 1997; 45:22-24.

De Silva HJ, Wijewickrema R, Senanayake N. Doespralidoxime affect outcome of management in acute organophosphorus poisoning? Lancet. 1992; 339:1136-38. https://doi.org/10.1016/0140-6736(92)90733-J

Sivagnanam S. Potential therapeutic agents in the management of organophosphorus poisoning. Crit Care. 2002; 6:260-61. https://doi.org/10.1186/cc1500 PMid:12133189 PMCid:PMC137451

Sungur M, Guven M. Intensive care management of organophosphate insencticide poisoning. Crit Care. 2001; 5:15-211. https://doi.org/10.1186/cc1025

Rossic J. Partial antagonism by cholinesterase reacti-vators of the effects of organophosphate compounds on shuttle-box avoidance. Arch Int Pharmacodyn. 1970; 183:139-47.

Sanderson DM. Treatment of poisoning by anticholi-nesterase insecticides in the rat. J Pharm Pharmacol. 1961; 13:435-39. https://doi.org/10.1111/j.2042-7158.1961.tb11849.x PMid:13746163

Du Toit PW, Muller FO, Nan Tonder MW. Experience with intensive care management of organophos-phate insecticide poisoning. SA Med Tydskrif. 1981; 60:227-29.

Buccafusco JJ, Aronstam RS. Clonidine protectionfrom the toxicity of soman, an organophosphate acetyl cholinesterase inhibitor, in the mouse. J Phar-macol Exp Ther. 1986; 239:43-47. PMid:3761196

Shadnia Sh, Esmaily H, Sasanian Gh, Pajoumand A, Hassanian-Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Human & Experimental Toxicology. 2007; 26:753–756. https://doi.org/10.1177/0960327107083017 PMid:17984147

Sokołowski R, Płusa T. Today's threat of use of organophosphorus compounds. Pol Merkur Lekarski. 2015; 39(231):176-80.

Costa LG. Organophosphorus Compounds at 80: Some Old and New Issues. Toxicol Sci. 2018; 162(1):24-35. https://doi.org/10.1093/toxsci/kfx266 PMid:29228398

Naguib M, Lien CA, Meistelman C. Pharmacology of neuromuscular blocking drugs. In: Miller RD, Eriksson LI, Cohen NH, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Millers? Anesthesia. 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone, 2015. p. 982.

Eddleston M, Chowdhury FR. Pharmacological treatment of organophosphorus insecticide poisoning: The old and the (possible) new. Br J Clin Pharmacol. 2016; 81:462–70. https://doi.org/10.1111/bcp.12784 PMid:26366467 PMCid:PMC4767211

Vijayakumar HN, Kannan S, Tejasvi C, Duggappa DR, Veeranna Gowda KM, Nethra SS.Study of Effect of Magnesium Sulphate in Management of Acute Organophosphorous Pesticide Poisoning.Anesth Essays Res. 2017; 11(1):192-196. https://doi.org/10.4103/0259-1162.194585 PMid:28298783 PMCid:PMC5341676

Pajoumand A, Shadnia S, Rezaie A, Abdi M, Abdollahi M. Benefits of magnesium sulfate in the management of acute human poisoning by organophosphorus insecticides. Hum Exp Toxicol. 2004; 23(12):565-9. https://doi.org/10.1191/0960327104ht489oa PMid:15688984

Basher A, Rahman SH, Ghose A, Arif SM, Faiz MA, Dawson AH.Phase II study of magnesium sulfate in acute organophosphate pesticide poisoning.Clin Toxicol (Phila). 2013; 51(1):35-40. https://doi.org/10.3109/15563650.2012.757318 PMid:23311540

Balali-Mood M, Balali-Mood K. Neurotoxic disorders of organophosphorus compounds and their managements. Archives of Iranian Medicine. 2008; 11(1):65-89. PMid:18154426

Syed M Ahmed, Bikramjit Das, Abu Nadeem, and Rajiv K Samal. Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation: A retrospective intensive care unit-based study in a tertiary care teaching hospital. Indian J Anaesth. 2014; 58(1):11–17. https://doi.org/10.4103/0019-5049.126780 PMid:24700893 PMCid:PMC3968644

Published

2018-11-15

How to Cite

1.
Jamshidi F, Yazdanbakhsh A, Jamalian M, Khademhosseini P, Ahmadi K, Sistani A, Jokar A. Therapeutic Effect of Adding Magnesium Sulfate in Treatment of Organophosphorus Poisoning. Open Access Maced J Med Sci [Internet]. 2018 Nov. 15 [cited 2024 Apr. 25];6(11):2051-6. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.350

Issue

Section

B - Clinical Sciences