Abstract
Blood organophosphate (OP) levels, serum butyrylcholinesterase (BChE) activity and electrophysiological neuromuscular transmission following repetitive nerve stimulation at 10 Hz and 50 Hz were studied serially in five patients with severe acute organophosphate intoxication following suicide attempts. Eight to 45 hours after oral ingestion, blood OP levels were elevated, BChE activity was markedly reduced, while repetitive nerve stimulation studies showed no or only mild abnormalities. The latter attained the maximal abnormality 32–69 h after ingestion, when BChE was inactivated further but elevated OP levels had fallen. Recovery from these abnormalities at 10 Hz nerve stimulation occurred within 100–237 h after the intoxication and it was still incomplete at 50 Hz stimulation 48–80 h later. BChE activity varied within a wide range and showed even normal values at both times. Neuromuscular transmission studies proved to be the most useful indicator for determining the severity and time course of organophosphate intoxication.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barnes JM, Duff JI (1953) The role of cholinesterase at the myoneural junction. Br J Pharmacol 8: 334–339
Barstad JAB (1960) Cholinesterase inhibition and the effect of anticholinesterases on indirectly evoked single and tetanic muscle contractions in the phrenic nerve-diaphragm preparation from the rat. Arch Int Pharmacodyn 128: 143–168
Besser R, Gutmann L, Dillmann U, Krämer G (1988a) End plate dysfunction in organophosphate intoxication. Neurology 8 (Suppl. 1): 396
Besser R, Dillmann U, Gutmann L, Schinzel K (1988b) Endplattenfunktion bei Alkylphosphatintoxikationen. Eine Methode zur Beurteilung von Gewebekonzentrationen. Intensivmed 25: 35–37
Braeckmann RA, Audenaert F, Willems JL, Belpaire FM, Bogaert MG (1983) Toxicokinetics of methyl parathion and parathion in the dog after intravenous and oral administration. Arch Toxicol 54: 71–82
Davies JA (1987) Changing profile of pesticide poisoning. N Engl J Med 316: 807–808
Faff J, Rabsztyn T, Rump S (1973) Investigations on the correlation between abnormalities of neuromuscular transmission due to some organophosphates and activity of acetylcholinesterase in the skeletal muscle. Arch Toxicol 31: 31–38
Grob D, Johns RJ, McGehee Harvey A (1956) Studies in neuromuscular function. V. Effects of anticholinesterase compounds, d-tubocurarine, and decamethonium in normal subjects. Bull J Hopkins Hosp 99: 195–218
Heffron PF, Hobbiger F (1979) Relationship between inhibition of acetylcholinesterase and response of the rat phrenic nervediaphragm preparation to indirect stimulation at higher frequencies. Br J Pharmacol 66: 323–329
Knolle J (1970) Die klinische Bedeutung der Cholinesterasebe stimmung im Blut bei akuten Intoxikationen mit phosphororganischen Insecticiden. Klin Wschr 48: 1157–1168
Namba T, Nolte CT, Jackrel J, Grob D (1971) Poisoning due to organophosphate insecticides. Acute and chronic manifestations. Am J Med 50: 475–492
Okonek S, Kilbinger H (1974) Determination of acetylcholine, nitrostigmine and acetylcholinesterase activity in four patients with severe nitrostigmine (E 605 forte) intoxication. Arch Toxicol 32: 97–108
Pena-Egido MJ, Rivas-Gonzalo JC, Marino-Hernandez EL (1988) Toxicokinetics of parathion in the rabbit. Arch Toxicol 61: 196–200
Schaumann W (1960) Beziehungen zwischen den peripheren und zentralen Wirkungen von Cholinesterase-Hemmern und der Inaktivierung der Cholinesterase. Arch Exp Path Pharmakol 239: 96–113
Senanayake N, Karalliedde L (1987) Neurotoxic effects of organophosphorous insecticides: an intermediate syndrome. N Engl J Med 316: 761–763
Wadia RS, Sadagopan C, Amin RB, Sardesai HV (1974) Neurological manifestations of organophosphorous insecticide poisoning. J Neurol Neurosurg Psychiatr 37: 841–847
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Besser, R., Gutman, L. & Weilemann, L.S. Inactivation of end-plate acetylcholinesterase during the course of organophosphate intoxications. Arch Toxicol 63, 412–415 (1989). https://doi.org/10.1007/BF00303132
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00303132