- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Part 15.1 Principles of management
- Part 15.2 Management of specific poisons
- Chapter 317 Management of salicylate poisoning
- Chapter 318 Management of acetaminophen (paracetamol) poisoning
- Chapter 319 Management of opioid poisoning
- Chapter 320 Management of benzodiazepine poisoning
- Chapter 321 Management of tricyclic antidepressant poisoning
- Chapter 322 Management of poisoning by amphetamine or ecstasy
- Chapter 323 Management of digoxin poisoning
- Chapter 324 Management of cocaine poisoning
- Chapter 325 Management of β-blocker and calcium channel blocker poisoning
- Chapter 326 Management of cyanide poisoning
- Chapter 327 Management of alcohol poisoning
- Chapter 328 Management of carbon monoxide poisoning
- Chapter 329 Management of corrosive poisoning
- Chapter 330 Management of pesticide and agricultural chemical poisoning
- Chapter 331 Management of radiation poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 1568) Management of pesticide and agricultural chemical poisoning
- Chapter:
- (p. 1568) Management of pesticide and agricultural chemical poisoning
- Author(s):
Elspeth J. Hulse
and Michael Eddleston
- DOI:
- 10.1093/med/9780199600830.003.0330
Poisoning with agricultural chemicals is common in rural Asia-Pacific with up to 300,000 annual deaths from pesticide self-poisoning. The pharmacokinetics and pharmacodynamics of pesticides can vary markedly depending on the chemicals ingested, the pesticide’s lipid solubility, enzyme reactivation, co-ingested toxicants, and extent of decontamination and organ dysfunction. Diagnosis and management is based on clinical signs and standard investigations. Staff should wear standard universal precaution attire for examining and treating patients; nosocomial poisoning is rare. Management of poisonings should include careful airway intervention and administration of oxygen, except in suspected paraquat poisoning. Organophosphorus insecticide poisoning causes a cholinergic crisis with excess airway secretions and acute respiratory failure. Patients should be treated with intravenous atropine and observed for the neuromuscular disorder ‘intermediate syndrome’, which can cause further paralysis and respiratory failure after 24 hours. Few antidotes exist for other agricultural chemical poisonings with the mainstay of treatment being supportive standard ICU care.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Part 15.1 Principles of management
- Part 15.2 Management of specific poisons
- Chapter 317 Management of salicylate poisoning
- Chapter 318 Management of acetaminophen (paracetamol) poisoning
- Chapter 319 Management of opioid poisoning
- Chapter 320 Management of benzodiazepine poisoning
- Chapter 321 Management of tricyclic antidepressant poisoning
- Chapter 322 Management of poisoning by amphetamine or ecstasy
- Chapter 323 Management of digoxin poisoning
- Chapter 324 Management of cocaine poisoning
- Chapter 325 Management of β-blocker and calcium channel blocker poisoning
- Chapter 326 Management of cyanide poisoning
- Chapter 327 Management of alcohol poisoning
- Chapter 328 Management of carbon monoxide poisoning
- Chapter 329 Management of corrosive poisoning
- Chapter 330 Management of pesticide and agricultural chemical poisoning
- Chapter 331 Management of radiation poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care