Incidence et caractéristiques des intoxications aux inhibiteurs de cholinestérases

The treatment of acute poisoning by pesticides is important parts of the activity of the Center for Emergency Medical Assistance Tunis (CAMU), which are mostly poisoning by inhibitors of cholinesterase (IC) activity, predominate. This prospective study included all adult patients hospitalized for emergency or reanimation of the CAMU; admitted to poisoning the IC during the period of six months from October 2008 to March 2009. The poisoning are all voluntary in nature with a female with urban origin in most cases. The miosis was the most common sign (95.5%), vomiting (76%), bradycardia (30%). Syndrome nicotinic was present in 22.7% and central (13.6%). The patients had biological signs emblematic of gravity, leukocytosis, hyperglycemia suggestive of intense adrenergic syndrome. Metabolic acidosis with hyperlactatemia was remarkable in this type of poisoning by IC but more important for the OP. Carbamate pesticides (CM) identified during these poisonings are: methomyl, carbofuran, bendiocarb, aldicarb and promecarb; for organophosphate (OP) were dichlorvos, diazinon, chlorpyrifos, malathion and ethyl parathion. The differentiation between the OP and the CM, is based on the kinetics of serum cholinesterase activity and globular. Identification of the toxic pesticide in question guided the severity of poisoning. Dichlorvos remains the most toxic in this study causing serious troubles.