Acute organophosphate insecticide poisoning

Organophosphates are irreversible acetylcholinesterase inhibitors. Intoxication with these compounds is a global health concern. Acute manifestations include muscarinic, nicotinic and central nervous system signs and symptoms. Diagnosis requires a high clinical index of suspicion. Treatment aims at decontamination, muscarinic and nicotinic antagonism, regeneration of acetylcholinesterase and supportive therapy. Subacute and chronic sequelae may occur following intoxication. The epidemiology, pathogenesis, clinical manifestations and sequelae of acute organophosphate intoxication are reviewed.