Reactivation of Plasma Butyrylcholinesterase by Pralidoxime Chloride in Patients Poisoned by WHO Class II Toxicity Organophosphorus Insecticides
Identifieur interne : 004517 ( Main/Curation ); précédent : 004516; suivant : 004518Reactivation of Plasma Butyrylcholinesterase by Pralidoxime Chloride in Patients Poisoned by WHO Class II Toxicity Organophosphorus Insecticides
Auteurs : Lisa A. Konickx ; Franz Worek ; Shaluka Jayamanne ; Horst Thiermann ; Nicholas A. Buckley ; Michael EddlestonSource :
- Toxicological Sciences [ 1096-6080 ] ; 2013.
Abstract
Some clinicians assess the efficacy of pralidoxime in organophosphorus (OP) poisoned patients by measuring reactivation of butyrylcholinesterase (BuChE). However, the degree of BuChE inhibition varies by OP insecticide, and it is unclear how well oximes reactivate BuChE
Url:
DOI: 10.1093/toxsci/kft217
PubMed: 24052565
PubMed Central: 3858199
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PMC:3858199Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Reactivation of Plasma Butyrylcholinesterase by Pralidoxime Chloride in Patients Poisoned by WHO Class II Toxicity Organophosphorus Insecticides</title>
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<author><name sortKey="Worek, Franz" sort="Worek, Franz" uniqKey="Worek F" first="Franz" last="Worek">Franz Worek</name>
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<author><name sortKey="Jayamanne, Shaluka" sort="Jayamanne, Shaluka" uniqKey="Jayamanne S" first="Shaluka" last="Jayamanne">Shaluka Jayamanne</name>
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<author><name sortKey="Thiermann, Horst" sort="Thiermann, Horst" uniqKey="Thiermann H" first="Horst" last="Thiermann">Horst Thiermann</name>
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<author><name sortKey="Eddleston, Michael" sort="Eddleston, Michael" uniqKey="Eddleston M" first="Michael" last="Eddleston">Michael Eddleston</name>
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<series><title level="j">Toxicological Sciences</title>
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<front><div type="abstract" xml:lang="en"><p>Some clinicians assess the efficacy of pralidoxime in organophosphorus (OP) poisoned patients by measuring reactivation of butyrylcholinesterase (BuChE). However, the degree of BuChE inhibition varies by OP insecticide, and it is unclear how well oximes reactivate BuChE <italic>in vivo</italic>
. We aimed to assess the usefulness of BuChE activity to monitor pralidoxime treatment by studying its reactivation after pralidoxime administration to patients with laboratory-proven World Health Organization (WHO) class II OP insecticide poisoning. Patient data were derived from 2 studies, a cohort study (using a bolus treatment of 1g pralidoxime chloride) and a randomized controlled trial (RCT) (comparing 2g pralidoxime over 20min, followed by an infusion of 0.5g/h, with placebo). Two grams of pralidoxime variably reactivated BuChE in patients poisoned by 2 diethyl OP insecticides, chlorpyrifos and quinalphos; however, unlike acetylcholinesterase reactivation, this reactivation was not sustained. It did not reactivate BuChE inhibited by the dimethyl OPs dimethoate or fenthion. The 1-g dose produced no reactivation. Pralidoxime produced variable reactivation of BuChE in WHO class II OP-poisoned patients according to the pralidoxime dose administered, OP ingested, and individual patient. The use of BuChE assays for monitoring the effect of pralidoxime treatment is unlikely to be clinically useful.</p>
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