760 ampollas de atropina utilizadas para tratar a un paciente con intoxicación grave por plaguicidas en un entorno de bajos recursos / 760 ampollas de atropina utilizadas 760 atropine ampules used to treat a patient with severe pesticide intoxication in a low resources setting

ABSTRACT

We reported the case of a 24-year-old male patient that arrived unconscious; with no identifable vital signs, a complete lack of response to pain stimuli and presented an extremely myotic pupils. Due to the report of his relatives we diagnosed an acute self-induced organophosphate (OP) intoxication through the ingestion of a full bottle of malathion. Endotracheal intubation, chest compressions, and manual ventilation were performed until the heart monitor showed slow myocardial activity. The patient was treated with atropine in the absence of specifc antidote (pralidoxime). A continuous peripheral IV infusion of atropine was started at a rate of 2 mg IV every 3 min. Given the constant decline in the patient's heart rate, the dose was constantly increased according to the vital sign chart until complete atropinization was achieved (heart rate over 120'). After administering a total of 760, 1 mg/ml ampules within 12 hours, a signifcant improvement was observed. The patient was discharged from the hospital 8 days later with no further complications