• Andrew M King and Cynthia K Aaron.
• Department of Emergency Medicine, Children's Hospital of Michigan Regional Poison Control Center, Detroit Medical Center, Wayne State University School of Medicine, 4707 Street Antoine, Suite 302, Detroit, MI 48201, USA. Electronic address: aking@dmc.org.
• Emerg. Med. Clin. North Am.. 2015 Feb 1;33(1):133-51.

AbstractOrganophosphates (OPs) and carbamates have a wide variety of applications, most commonly as pesticides used to eradicate agricultural pests or control populations of disease-carrying vectors. Some OP and carbamates have therapeutic indications such as physostigmine. Certain organophosphorus compounds, known as nerve agents, have been employed in chemical warfare and terrorism incidents. Both classes inhibit acetylcholinesterase (AChE) enzymes, leading to excess acetylcholine accumulation at nerve terminals. In the setting of toxicity from either agent class, clinical syndromes result from excessive nicotinic and muscarinic neurostimulation. The toxic effects from OPs and carbamates differ with respect to reversibility, subacute, and chronic effects. Decontamination, meticulous supportive care, aggressive antimuscarinic therapy, seizure control, and administration of oximes are cornerstones of management.Copyright © 2015 Elsevier Inc. All rights reserved.

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