Manousakis A.^*, Tsatsakis A.M.^*, ^*, Tzatzarakis M.^*, Anastasakis M.^**, Agouridakis P.^**

^* Toxicology Laboratory, Medical School, University of Crete, Stavrakia, Iraklion, PO Box 1393, 71409 Crete, Greece
^** The Intensive Care Unit, University Hospital, Stavrakia, Iraklion, 71409 Crete, Greece

Two patients suffering from Fenthion and Omethoate acute poisoning are presented. Both victims were admitted in the Intensive Care Unit (ICU) a few hours after ingestion and received the appropriate treatment for organophosphorous poisoning (gastric lavage, activated charcoal, atropine and pralidoxime) and supportive care according to the protocol obtained from our experience in management of such cases. Both survived. Organophosphate blood levels were measured on admission and during therapy and proved to be considerably high. The slow elimination rate of the poison already distributed in the organism was indicated for both pesticides. Poison levels and acetylcholinesterase activity, monitored through out the treatment period, are presented. The patient with Omethoate poisoning remained clinically well with a few mild symptoms and was discharged three days later. The patient with Fenthion poisoning, who had also received 30 mg Bromazepam (Lexotanil^®) and 720 mg Oxetoron (Nocetron^®), in an attempt to commit suicide, developed cholinergic crisis several hours (>6) after her admission, with plasma cholinesterase activity reduced to 10-15% normal. She was intubated and mechanically ventilated for 24 days, with concomitant complications.
Conclusion. Cholinergic crisis was expected to occur in the next few hours after Fenthion ingestion. We believe that Bromazepam ingestion played a role in this observed delay. Omethoate is a new pesticide and in the bibliography reviewed no human poisoning was reported.