Magnesium Sulphate With Atropine and Pralidoxime vs Standard Therapy Alone in Acute Organophosphate Poisoning

Comparison of the Efficacy of Adjunctive Magnesium Sulphate With Standard Atropine and Pralidoxime Therapy vs Standard Therapy Alone in Acute Organophosphate Poisoning

Pakistan, being a developing country, is one of the regions with the most cases of organophosphate (OP) poisoning/toxicity. MgSO4 is one of the most promising adjunctive treatments that needs to be tested. This study is being carried out with the objective of comparing the 15-day all-cause mortality rate and the total cumulative atropine requirement during hospitalization between patients receiving adjunctive magnesium sulphate with standard therapy and those receiving standard therapy alone.

The current standard therapy in OP is lacking in managing the Intermediate Syndrome (IMS) and the delayed complications. This deficiency underscores the need for carrying out research to test the efficacy of adjunct compounds in the better management of the toxicity of this deadly substance. MgSO4 is one of the most promising adjunctive treatments that needs to be tested. In a setting where economic instability and a compromised health system put an uneven burden on the shoulders of the patient, introducing a regimen that could possibly reduce the hospital stay and prevent the use of ventilators can be very healthy for the pockets of the government bodies as well as the patient's attendants. Assessing atropine consumption, need for mechanical ventilation, incidence of respiratory failure due to IMS, length of hospital admission, and mortality in the treatment would enable clinicians to recognize whether the adjunctive treatment is efficacious in achieving reasonable outcomes or not.

Inclusion Criteria:

• Both genders
• Adult patients aged between 18 and 50 years
• Confirmed clinical diagnosis of organophosphate poisoning containing insecticide, through the oral route
• Adult patients, or their legally authorized representative, who will provide informed consent to participate in the study

Exclusion Criteria:

• Patients with known allergy to MgSO4
• Patients with documented pre-existing renal impairment (Serum creatinine more than 1.5mg/dl)
• Patients with documented pre-existing cardiac impairments (e.g., heart block)
• Pregnant or lactating women
• Confirmed intake of any other drug or poison
• Patients who will be declared dead on arrival or those who expired within 2 hours of presentation