OPC Poisoning

Clinical Features:

• 1)CVS: Hypotension & Bradycardia
• 2)Respiratory :broncho-Constriction,Cough,Rhinorrhea.
• 3) GIT: Salivation, Nausea,vomiting, abdominal pain,Diarrhoea 
• 4)urinary incontinence 
• 5)Blurred vision & increase lacrimation
• 6)muscle weakness, Fusiculation, cramps & paralysis
• 7)Anxiety, restlessness, dysarrthia,insomnia 

On examination:

• 1) Pupil : Pin point or not 
• 2) BP : 

Investigations:

• 1)CBC 
• 2)Serum Electrolyte 
• 3)RBS
• 4)serum creatinine 
• 5)ECG 
• 6)LFT 
• 7) ABG 

Rx:

• Hopitalization
  
• NPO- TFO 
  
• O2 inhallation sos
  
• Stomach wash immediately
  
•  Catheterization of Patient
  

1. Inf. 5% DNS (1L) + N/S (1L) +5% DA (1L)

• IV @ 30 d/min

2.  Inj. Ceftron(1gm)(Ceftriaxone)

• 1vial I/V ...........BD

3. Inj.Sergel (40mg)(Esomeprazole)

• 1 vial I/V ......... BD

4.  Inj. Atropine

• 2 amp I/V stat & double the dose
  

10 min interval up to atropinization

5. Inj. Pradox (Pralidoxime)(500mg)

• 2 amp IV slowly over 10-20 min &Then 1amp I/V- BD

Maintance Dose-Atropine:

• 10% of Atropinization Dose.....apmle in each bag(1L) Fluid.
  

Example: 

If (2+4+8+16 =30 amp) 

10% = 3 amp maintainance দিবো প্রতি 1L fluid এ 

If restlessness: 

Inj. Sedil(Diazepam)(10mg/2ml)

1 amp I/M stat 

if Restlessness  not controlled

inj.Halopid(Haloperidol)(5mg/ml)

• 1 amp I/M stat& BD
  

Inj.Cyclid(Procyclidine)(10mg/ml)

• 1 amp I/M stat & BD
  

Discharge From hospital:

1. Cap.Denver(200mg)(Cefixime)

1+0+1.............7 days

2. Tab.Acifix(20mg)(Rabeprazole)

1+0+1.............10 days

3. Tab.Zovia gold/Silver(multivitamin)

1+0+1.............1 month

4. Tab.Esita(10mg)(Escitalopram)

1+0+0.............1 month 

5. Tab.Propa(15mg)(propantheline bromide)

1+1+1..........15 days

Advice:

• Follow up after 7  days.