Organophosphate and Carbamate Toxicosis
Basic Information
Epidemiology
Risk Factors
Farm animals are at a higher risk because of the common use of these chemicals in a farm setting.
Clinical Presentation
Physical Exam Findings
• The clinical signs observed are associated with muscarinic, nicotinic, and central nervous system (CNS) stimulation.
• Muscarinic receptor–associated effects include salivation, lacrimation, urination, diarrhea, miosis (pinpoint pupils), and lung edema.
• Bradycardia, bronchoconstriction, and bronchorrhea may also be observed.
• Nicotinic receptor–associated effects are related to the stimulation of autonomic ganglia and skeletal muscles. The clinical signs of nicotinic stimulation include muscle twitching, tremors, and seizures.
• CNS stimulation can cause depression, hyperactivity, and seizures.
Etiology and Pathophysiology
• Organophosphates and carbamates inhibit the enzyme acetylcholinesterase, which is within nerve tissue and at neuromuscular junctions. Acetylcholinesterase destroys the neurotransmitter acetylcholine.
• When the acetylcholine concentrations increase in nerve tissue or at the neuromuscular junction, the acetylcholine receptors become overstimulated.
• The cholinergic system is widely distributed within the CNS and peripheral nervous system. There is a wide range in clinical signs when the cholinergic system is upregulated.