The incidence of carbamate insecticide poisoning has increased gradually in recent years, and anticholinergic drugs are the specific antidotes. In 2020, the Peking University Third Hospital admitted a patient with carbamate insecticide poisoning, whose main clinical manifestations were dizziness, vomiting and blurred vision. During the treatment with penehyclidine hydrochloride, the patient developed delirium. This paper retrospectively analyzed the clinical data and treatment process of the patient to improve people's understanding of the side effects of penhyclidine hydrochloride in the treatment of insecticide poisoning.
Humans ; Insecticides ; Retrospective Studies ; Hydrochloric Acid ; Carbamates/therapeutic use* ; Delirium ; Poisoning/therapy* ; Organophosphate Poisoning/drug therapy*

Acute Disease ; Animals ; Antidotes ; therapeutic use ; Mice ; Organophosphate Poisoning ; Poisoning ; drug therapy ; Rats

Atropine ; therapeutic use ; Humans ; Organophosphate Poisoning ; Poisoning ; drug therapy ; Quinuclidines ; therapeutic use

OBJECTIVETo observe the effect of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning.

METHODSA total of 67 eligible patients with acute phoxim pesticide poisoning, Who were admitted to the emeryency department of hospital from March 2011 to February 2014, Acording to different treatments au patients were randomly divided into the conventional treatment group (n=34) and the sodium bicarbonate+ulinastatin group (n=35) . The conventional treatment group were given thorough gastric lavage with water, the sodium bicarbonate + ulinastatin group were given gastric lavage with 2% sodium bicarbonate solution. Both groups were given such treatments as catharsis, administration of oxygen, fluid infusion, diuresis, and antidotes such as atropine and pralidoxime methylchloride. On the basis of comprehensive treatment, people in the sodium bicarbonate+ulinastatin group were given 5% sodium bicarbonate injection and ulinastatin. The clinical effect of the two groups were compared.

RESULTSThe serum cholinesterase activity of the sodium bicarbonate+ulinastatin group was significantly higher than the conventional treatment group from the 5th day, and the difference was statistically significant (P<0.05) . The total atropine dosage, total pralidoxime methylchloride dosage and hospitalization days were better than the conventional treatment group, and the differences were statistically significant (P<0.05) . The difference in the time of atropinization between the two groups was not statistically significant (P>0.05) . The results of arterial blood pH, HCO3- of the sodium bicarbonate + ulinastatin group were higher than the conventional treatment group, and the difference of HCO3- at the 10th day was statistically significant (P<0.05) .

CONCLUSIONSSodium bicarbonate combined with ulinastatin can improve the therapeutic effect and reduce complications in the treatment of acute phoxim pesticide poisoning, and have beneficial effects on the recovery of cholinesterase activity.

Atropine ; therapeutic use ; Cholinesterases ; metabolism ; Glycoproteins ; therapeutic use ; Humans ; Organophosphate Poisoning ; drug therapy ; Organothiophosphorus Compounds ; poisoning ; Pesticides ; poisoning ; Pralidoxime Compounds ; therapeutic use ; Sodium Bicarbonate ; therapeutic use

Acute Disease ; Adult ; Antidotes ; therapeutic use ; Antiparkinson Agents ; therapeutic use ; Benserazide ; Cholinesterase Inhibitors ; poisoning ; Humans ; Insecticides ; poisoning ; Levodopa ; therapeutic use ; Male ; Organophosphate Poisoning ; Parkinson Disease ; drug therapy ; pathology ; Pralidoxime Compounds ; therapeutic use ; Trihexyphenidyl ; therapeutic use

Adult ; Creatine Kinase, MB Form ; metabolism ; Drug Therapy, Combination ; Electrocardiography ; Female ; Heart ; drug effects ; physiopathology ; Humans ; Hypoglycemic Agents ; therapeutic use ; Insecticides ; poisoning ; Insulin ; therapeutic use ; Isoflavones ; therapeutic use ; L-Lactate Dehydrogenase ; metabolism ; Male ; Myocarditis ; chemically induced ; drug therapy ; Myocardium ; enzymology ; pathology ; Organophosphate Poisoning ; Treatment Outcome ; Vasodilator Agents ; therapeutic use