Revisão integrativa : atropina e oximas nas intoxicações agudas por carbamatos e organofosforados

Abstract

The study searched, categorized and summarized scientific evidence of the last decade for both the use of atropine and oxime in poisoned patients’ therapy for carbamates and organophosphates insecticides. Conducted through an integrative review, use articles found in the collections: Biblioteca Virtual em Saúde, Portal de Periódicos da CAPES/MEC and Medline. A total of 270 search results were analyzed, including a total of 74 articles, which were categorized by methodology assessing the level of evidence on the subject in each collection. The result was mostly low evidence of articles, but seven high evidence items were selected. Use of atropine to poisoning carbamates and organophosphates is well established, the analysis of studies indicated that rapid atropinization may be beneficial for intoxicated patients, but the amount of evidence was insufficient to establish that such a relationship is absent of doubt, requiring further studies to confirm this hypothesis. Use of oximas in therapy for carbamate poisonings is not recommended. The analysis of statistically significant outcomes of each selected study resulted in the absence of evidence of benefit from the use of oximes for patients poisoned by organophosphates, with evidence of major adverse reactions, increased need for hospital support and possible increased mortality.