[The effect of neostigmine on the motor endplate in the intermediate syndrome of organophosphate poisoning].

R Besser
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Abstract

A patient with severe organophosphate intoxication received Neostigmine 1 mg IV during the intermediate syndrome. This dose resulted clinically and neurophysiologically in a marked deterioration of neuro-muscular transmission. This effect of neostigmine on the neuromuscular block during the intermediate syndrome (deterioration) differs from its effect on a similar pattern (improvement), which is seen in the delayed neuropathy following organophosphate exposure. The administration of therapeutic doses of cholinesterase inhibitors in patients with a reduced safety margin due to inhibition of endplate acetylcholinesterase may be dangerous.

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新斯的明对有机磷中毒中间综合征运动终板的影响。
1例重度有机磷中毒患者在中间综合征期间接受新斯的明1 mg IV治疗。这一剂量在临床上和神经生理学上导致神经肌肉传递的显著恶化。新斯的明对中间综合征(恶化)期间神经肌肉阻滞的影响不同于其对类似模式(改善)的影响,后者见于有机磷暴露后的延迟性神经病变。对因终板乙酰胆碱酯酶抑制而安全边际降低的患者使用治疗剂量的胆碱酯酶抑制剂可能是危险的。
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