ATROPINE AEROSOL SPRAY (AAS) BY NASAL APPLICATION IN ORGANOPHOSPHATE POISONING

Atropine aerosol spray (AAS) was used to treat three organophosphorus (OP)-intoxicated patients to determine if alternate routes of drug administration were as efficacious as intramuscular or intravenous routes when treating OP poisoning. Case I was a seriously intoxicated 20-year-old man classified as Namba IV (severe poisoning). Case II was a 25-year-old man classified as Namba II (mild poisoning), with bradyarrhythmia. Case III was a 23-year-old cyanotic, unconscious man with marked miosis and increased salivation, classified as Namba IV (severe poisoning). The recommended AAS dosing regimen used was 3 puffs every 10–15 minutes. Each puff contained 2 mg atropine sulphate, which is equivalent to 1.67 mg atropine free base. After AAS applications, salivation, diarrhea, and sweating diminished in all patients (where applicable). Additionally, in Case II, bradyarrhythmia converted to sinus rhythm. In conclusion, AAS dosage of nearly 30–35 mg/day (5–6 times/day) is an effective route to administer atropine sulphate for systemic use in patients who are poisoned by OP insecticides. Clinical findings suggest that significant systemic absorption occurs within 5 minutes of AAS application