Role of penehyclidine in acute organophosphorus pesticide poisoning

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 identifi ed for meta-analysis. Main outcomes included 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 identifi ed. Compared with the atropineor 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 signifi cantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS. CONCLUSION: Atropine combined with penehyclidine benefi ts 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.

Removal of Pesticides from Waters by Adsorption: Comparison between Synthetic Zeolites and Mesoporous Silica Materials. A Review

“…The toxicity of pesticides can be categorized as acute or chronic. Acute illness generally emerges after a short time of contact with the pesticide [12,13]. Suspected chronic effects resulting from regular exposure to small doses of certain pesticides may include birth defects, toxicity to fetus, genetic changes, blood, and nerve disorders.…”

Efficacy and Safety of Plasma Exchange Combined with Hemoperfusion in the Treatment of Organophosphorus Poisoning: A Meta-Analysis

“…Organophosphorus poisoning is a common type of pesticide poisoning, often accompanied by accidents or suicides, especially in developing countries [1][2][3]. More than 300,000 people worldwide die from oral organophosphorus pesticides each year, accounting for about 30% of the suicide population [4][5][6].…”

Application of Shewhart Control Chart in Controlling Adverse Events in Patients with Severe Acute Organophosphorus Pesticide Poisoning Undergoing Blood Purification

“…Organophosphate pesticides (OPS) have been widely used in agricultural and forestry pest control worldwide since the 1930s due to their strong insecticidal effect and low cost [ 1 ]. However, in developing countries, especially in Asian countries, the lack of drug supervision and control often leads to acute organophosphorus pesticide poisoning (AOPP) [ 2 ]. AOPP is acute, with typical symptoms of salivation, sweating, pupil constriction, and muscle tremors.…”