Organophosphates: New Antidotes from Old Drugs

Andrew, Dawson. "Organophosphates: New Antidotes from Old Drugs." Journal of the Indian Society of Toxicology 2, no. 1 (2006).


Asia carries a disproportionate burden of illness from acute and chronic toxicity. Organophosphate pesticides contribute substantially to the burden of illness. For many years this class of pesticides had been treated as a relatively homogenous group of chemicals. However it is clear that this is not the case and that there is considerable variation in toxicokinetics and dynamics which produces different clinical syndromes. This has implications for clinical treatment and regulatory and public health responses. Understanding this variation helps us to understand the limitations and also refine our current treatments.

In this setting we need to reassess the role of older antidotes and examine the potential of other therapeutic agents in the treatment of OP poisoning. Many of these agents have been extensively tested in organophosphate poisoned animals and have been used in humans for other indications. They may have important therapeutic role by addressing other mechanisms of poisoning compared to traditional antidotes. Such drugs include clonidine, diazepam and magnesium. These drugs are all included in the SACTRC research agenda The challenge in our region is to deliver treatment that is accessible and affordable. Perhaps the new advances in antidotes will come from well known old drugs.