Anticholinesterases and Organophosphate Poisoning
Cholinesterase inhibitors, their therapeutic uses, and the toxicology and management of organophosphate / carbamate poisoning
Past RGUHS + DNB + MPMSU + MUHS · 17
RGUHSMay '25
MPMSUMay '25
DNBOct '23
MPMSUMay '19
RGUHSNov '18
RGUHSMay '18
RGUHSNov '17
MUHSSummer '16
MPMSU2014
MPMSU2014
MUHSWinter '14
MUHSWinter '14
RGUHSOct '10
RGUHSMay '10
MPMSU2010
RGUHSMay '09
MPMSU2009
Introduction
- Definition — Anticholinesterases (anti-ChEs) inhibit cholinesterase, protect acetylcholine (ACh) from hydrolysis, and so amplify cholinergic transmission throughout the CNS and PNS.
- Two enzymes — They inhibit both acetylcholinesterase (AChE) and butyrylcholinesterase (BChE, pseudocholinesterase) — hence "anti-ChE", not simply "AChE inhibitor".
- Therapeutic span — Used in myasthenia gravis, glaucoma, post-operative ileus/bladder atony, reversal of competitive neuromuscular block, Alzheimer's disease, and as the antidote to antimuscarinic poisoning.
- Toxicological importance — The class includes the single most important toxicology problem — organophosphate (OP) and carbamate insecticide poisoning plus chemical-warfare nerve agents (sarin, soman, VX).
- Prototype — Physostigmine (Calabar-bean alkaloid, the original miotic/antidote) and neostigmine (synthetic, myasthenia gravis) are the prototypes.
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Anticholinesterases Op Poisoning
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