Modern aspects of development of basic therapy and prevention means of organophosphorus compounds acute poisoning (review of literature)

Abstract

Introduction. Despite large experience in the use of basic therapies for acute poisoning by organophosphorus compounds (OPs)of anticholinesterase action and the results of research conducted in the world, the current methods of treatment of such poisonings are insufficient and do not meet requirements for effective treatment and health. Purpose. Based on the analysis of scientific publications to outline the main directions of modern developments of drugs for basic therapy and prevention of acute OPs poisoning at the stages of their experimental assessment. Methods. A systematic content analysis of literature data using the PubMed database was performed. Results. Modern principles of pharmacotherapy of acute anticholinesterase OPs poisoning are based on the use of anticholinergic drugs (mainly atropine), cholinesterase reactivators and anticonvulsant action. M-cholinolytic therapy remains a mandatory basic component of the treatment of acute OPs poisoning. Today, research is aimed at finding less toxic M-cholinolytics with a wider range of therapeutic effects. A cholinesterase reactivator has not yet been developed that has such a spectrum of action that is able to prevent the central effects of OPs poisoning. The effectiveness of the combined action of AChE reactivators has also been insufficiently studied. One approach to solving the problem of protecting the central nervous system in OPs poisoning may be to find a combination of peripheral cholinesterase reactivators with neuroprotectors capable of overcoming the blood-brain barrier. The development of anticonvulsant therapeutic agents requires further study of the mechanism of status epilepticus in acute OPs poisoning. Conclusions. There is an intensive search for OPs poisoning treatments around the world. But in time the relevance and importance of finding and implementing a unified methodology for studying the therapeutic efficacy of a wide range of pharmacological agents at the stage of their preclinical evaluation. Efforts to find means of pharmacologically correcting OPs poisoning should be accompanied by the development of a more prudent regulatory policy in the field of pesticide use. It is also necessary to create a clear and consistent policy on information measures that would focus on the dangers of OPs, as well as contribute to the prevention of mental disorders that provoke suicidal consequences. Key Words: organophosphorus compounds, acute poisoning, means of basic therapy, means of prevention.