It is important to remember that atropine has no effect on severe muscular paralysis. Respiratory support is therefore vital in OP patients. Pulmonary edema is countered by intravenous Lasix 20-40 mg, and by using a mechanical ventiltor to give oxygen under pressure. Pralidoxime is not easily available. Treatment with pralidoxime should be repeated after 30 minutes if respiration does not improve.
Prognosis is good if prompt action is taken as soon as the diagnosis is made.
Any delay in starting treatment may be costly. Community education in the rural areas where small or large-scale farming is practiced is very important. Prevention is better than cure. Doctors working in primary care centers must be aware of the dangers posed by organophosphorus compounds used by farmers. Questions should always be asked about exposure to insecticides whenever a patient is brought to their clinic comatose and with constricted pupils, particularly in agricultural areas, where their use may be prevalent.