Titrate pam dosage according to serum cholinesterase level in the management of acute organophosphate poisoning

20 patients hospitalized from 1998 to 2000 due to acute organophosphate poisoning were treated by intravenous infusion of PAM at dose of 0.25g - 1g per hour. The dosage of PAM was adjusted according to concentrations of serum cholinesterase tested every 12 hours. The results of study showed that the clinical status was significantly improved: in-hospital stay time was shorter, dose of atropine was lower, severe complications such as paralysis, respiratory failure were decreased in comparison to previous studies. Thus, the level of serum cholinesterase is correlated to poisoning severity and is good indicator for adjustment of PAM dosage in the management of acute organophosphate poisoning.