Role of penehyclidine in acute organophosphorus pesticide poisoning
10.5847/wjem.j.1920–8642.2020.01.006
- Author:
Shi-yuan Yu
1
;
Yan-xia Gao
2
;
Joseph Walline
3
;
Xin Lu
1
;
Li-na Zhao
1
;
Yuan-xu Huang
4
;
Jiang Tao
4
;
An-yong Yu
5
;
Na Ta
6
;
Ren-ju Xiao
7
,
8
;
Yi Li
1
Author Information
1. Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College and ChineseAcademy of Medical Sciences, Beijing, China
2. Department of Emergency Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
3. Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, the Chinese University of Hong Kong, HongKong, China
4. Department of Emergency Medicine, the Fourth Affiliated Hospital of Jishou University, Huaihua, China
5. Department of Emergency Medicine, the First Affiliated Hospital of Zunyi Medical University, Zunyi, China
6. Department of Emergency Medicine, Chifeng Municipal Hospital, Chifeng, China
7. Department of Emergency Medicine, Xingyi People'
8. s Hospital, Xingyi, China
- Publication Type:Journal Article
- Keywords:
Penehyclidine;
Organophosphorus pesticide poisoning;
Meta-analysis
- From:
World Journal of Emergency Medicine
2020;11(1):37-47
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients.
METHODS:We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomesincluded cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR).
RESULTS:Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine-or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07–1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01–1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06–0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04–1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS.
CONCLUSION:Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.
- Full text:006 WJEM-2019-0025.pdf
