Cholinesterase-inhibiting insecticide toxicity.

Organophosphate toxicity can be fatal. It accounts for almost 40 percent of all insecticide- and pesticide-related illnesses reported by the American Association of Poison Control Centers. Skin contamination is the most important route of occupational exposure. Carbamate insecticides exhibit a similar mechanism of acute toxicity. Organophosphate pesticides act as irreversible acetylcholinesterase inhibitors, while carbamate pesticides produce reversible effects. The inhibition of acetylcholinesterase causes accumulation of acetylcholine at nerve endings, resulting in a cholinergic or hypersecretory syndrome. Persons who are exposed to organophosphates must be admitted to the hospital for careful observation. Symptoms should be treated with atropine, and most patients should also receive pralidoxime, a cholinesterase-regenerating drug.