Which organ systems may be affected by organophosphate (OP) toxicity?

Updated: Dec 31, 2020
  • Author: Kenneth D Katz, MD, FAAEM, ABMT; Chief Editor: Sage W Wiener, MD  more...
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Organophosphate toxicity may affect other organ systems as follows:

  • Ophthalmic: Optic neuropathy, retinal degeneration, defective vertical smooth pursuit, myopia, and miosis (due to direct ocular exposure to organophosphates)

  • Ears: Ototoxicity is possible

  • Respiratory: Muscarinic, nicotinic, and central effects contribute to respiratory distress in acute and delayed organophosphate toxicity

  • Muscarinic effects: Bronchorrhea, bronchospasm, and laryngeal spasm, for instance, can lead to airway compromise; respiratory failure is the most life-threatening effect and requires immediate intervention

  • Nicotinic effects: These effects lead to weakness and paralysis of respiratory oropharyngeal muscles

  • Central effects: These effects can lead to respiratory paralysis

  • Cardiac rhythm abnormalities: Sinus tachycardia, sinus bradycardia, extrasystoles, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation (often a result of, or complicated by, severe hypoxia from respiratory distress) are possible

  • Other cardiovascular effects: Hypotension, hypertension, and noncardiogenic pulmonary edema are possible

  • Gastrointestinal manifestations: Nausea, vomiting, diarrhea, and abdominal pain may be some of the first symptoms to occur after organophosphate exposure

  • Genitourinary and/or endocrine effects: Urinary incontinence, hypoglycemia, or hyperglycemia is possible

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