Both @entity5139 (OP) and @entity2961 insecticides inhibit @entity10810 ( @entity10810 ), which results in accumulation of @entity934 ( @entity3451 ) at autonomic and some central synapses and at autonomic postganglionic and neuromuscular junctions. As a consequence, @entity3451 binds to, and stimulates, muscarinic and nicotinic receptors, thereby producing characteristic features. With OP insecticides (but not @entity9159 ), "aging" may also occur by partial dealkylation of the @entity563 group at the active site of @entity10810 ; recovery of @entity10810 activity requires synthesis of new enzyme in the liver. Relapse after apparent resolution of cholinergic symptoms has been reported with OP insecticides and is termed the intermediate syndrome. This involves the onset of @entity4589 affecting particularly upper-limb muscles, neck flexors, and cranial nerves some 24-96 hours after OP exposure and is often associated with the development of @entity1576 . OP-induced delayed @entity16 results from phosphorylation and subsequent aging of at least 70% of @entity16 . Cramping @entity925 in the lower limbs, distal numbness, and paresthesiae are followed by progressive weakness, @entity308 in the lower limbs and, in severe cases, in the upper limbs. The therapeutic combination of @entity5140 , @entity3897 , and @entity3175 is well established experimentally in the treatment of OP pesticide @entity4968 . However, there has been controversy as to whether @entity5141 improve morbidity and mortality in @entity1 @entity4968 . The explanation may be that the solvents in many formulations are primarily responsible for the high morbidity and mortality; @entity5141 would not be expected to reduce @entity137 in these circumstances. even if given in appropriate dose.

@entity5139 and @entity2961 insecticide XXXX .

@entity1 :: ('9606', 'Species') :: ['human'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression of deep tendon reflexes'] @entity3175 :: ('MESH:D003975', 'Chemical') :: ['diazepam'] @entity9159 :: ('MESH:D002219', 'Chemical') :: ['carbamates'] @entity563 :: ('CHEBI:17822', 'Chemical') :: ['serine'] @entity4589 :: ('MESH:D012133', 'Disease') :: ['muscle paralysis'] @entity5141 :: ('MESH:D010091', 'Chemical') :: ['oximes'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neuropathy target esterase', 'neuropathy'] @entity4968 :: ('MESH:D011041', 'Disease') :: ['poisoning'] @entity2961 :: ('CHEBI:28616', 'Chemical') :: ['carbamate'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure'] @entity3451 :: ('D000109', 'Chemical') :: ['ACh'] @entity10810 :: ('43', 'Gene') :: ['AChE', 'acetylcholinesterase'] @entity3897 :: ('MESH:D001285', 'Chemical') :: ['atropine'] @entity925 :: ('MESH:D063806', 'Disease') :: ['muscle pain'] @entity5139 :: ('D010755', 'Chemical') :: ['organophosphorus'] @entity5140 :: ('CHEBI:25750', 'Chemical') :: ['oxime'] @entity934 :: ('MESH:D000109', 'Chemical') :: ['acetylcholine']
@entity4968 :: (MESH:D011041,Disease) :: ['poisoning']
