Autor: Izabella Danezi Felin | Publicado: 2017-06-26T11:03:00-03:00

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<![endif]--> Projeto PATONLINE estuda,
revisa e compartilha conhecimentos relativos aos avanços/ condutas&nbsp; na área Médica:&nbsp;





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INTOXICAÇÕES POR ORGANOFOSFORADOS




Segundo a Organização Mundial da Saúde (OMS),
registram-se no mundo a cada ano 25 milhões de casos de envenenamento por
agrotóxicos com cerca de 20 mil mortes involuntárias. Guardar em ambiente
adequado, ajuda a reduzir significativamente os riscos de envenenamento e
óbitos. Na rotina de atendimento em toxicologia, preconiza-se a identificação
do agente para tomada de medidas específicas. Nos casos de intoxicações por
organofosforados, a peculiaridade do quadro clínico pode elucidar o diagnóstico
correto. As intoxicações principalmente por organofosforados, apresentam alta
incidência. Apesar disso, ainda é escassa a quantidade de referências
bibliográficas sobre o assunto, que também não é muito enfatizado em níveis
acadêmico e profissional. Os agrotóxicos organofosforados mais usados no Brasil
são, lamentavelmente, todos da Classe I, os mais tóxicos que existem:
Monocrotofos, Folidol (Parathion) e Malation. Outro é o Tamaron, que hoje é
comercializado como Classe II (“altamente tóxico”). Tais produtos são usados em
diversos tipos de plantações para combater pragas, nos domicílios contra moscas
e mosquitos, além de serem empregados por órgãos de saúde pública no combate a
vetores de doenças (p.ex.: o Aedes aegypti). Em plantações é aplicado em
diversas culturas, como a de alho, cebola, trigo, arroz, milho, frutos,
hortaliças, feijão, batata, algodão, amendoim, soja, cacau, café, centeio e
fumo. &nbsp;As vias dérmica e pulmonar são as
mais comumente vistas na exposição ocupacional, enquanto a via oral é a mais
comum em casos de envenenamento não ocupacional, como&nbsp; a que normalmente se vê por ingesta acidental
em crianças. Os organofosforados são compostos agrotóxicos, de ampla
comercialização no Brasil, que inibem a enzima acetilcolinesterase, estimulando
excessivamente os receptores da acetilcolina. Os receptores da acetilcolina são
neurotransmissores em todas as terminações nervosas autonômicas preganglionares
(receptores nicotínicos), todas as terminações parassimpáticas e algumas
terminações nervosas simpáticas pos-ganglionares (receptores muscarínicos),
junção neuromuscular (receptores nicotínicos) e em algumas sinapses do SNC. A
superestimulação desses receptores da acetilcolina por inibição da
acetilcolinesterase, provoca sintomas muscarínicos e nicotínicos que fazem
parte da síndrome clínica tóxica, também chamada de síndrome colinérgica por
organofosforados que inclui possíveis manifestações do sistema nervoso central
(SNC), como: alterações do estado mental, fraqueza muscular e atividade
secretória excessiva