This book addresses the consequences of high agricultural pesticide use over the last few decades in the form of organophosphate poisoning. The authors provide a background overview of organophosphate compounds, their environmental toxicity, non-target exposures and cases of human poisoning. The authors also compile and analyze data from the last two decades to demonstrate the toxicological aspects of organophosphates, and how they can pose a threat to human health. Readers will learn about the clinical manifestation of organophosphate exposure in humans, as well as the enzymatic pathways and mechanisms by which organophosphates are processed in the body and cause harm. The book concludes by providing techniques, practices and recommendations for how to manage organophosphate exposure and poisoning. It will be useful for clinicians and public health professionals, scientists, medical practitioners, researchers and environmental toxicologists.

Chapter 1: Overview of Organophosphate Compounds 1.1 Introduction 1.2 Classification, Properties, and Synthesis of Organophosphates 1.2.1 Classification 1.2.2 General Properties 1.2.3 Physicochemical Properties and Structure-Activity Relationships 1.2.4 Synthesis 1.3 Applications 1.3.1 Agriculture 1.3.2 Industry 1.3.3 Nerve Agent or Warfare Agent 1.4 OP Poisoning in Biotic and Abiotic Components 1.4.1 Biotic Component 1.4.1.1 Human 1.4.2 Aquatic and Marine Life 1.4.3 Soil Biota 1.5 Abiotic Component 1.5.1 Water 1.5.2 Soil 1.5.3 Air 1.6 The Major Concern and Future Prospects References Chapter 2: Toxicology of Organophosphate Poisoning in Human 2.1 Introduction 2.2 Pathophysiology and Clinical Manifestation 2.2.1 Receptor-Specific Manifestations 2.2.2 Duration-Based Manifestations 2.2.3 Organs-Specific Manifestations 2.2.3.1 Neurological Manifestations 2.2.3.2 Cardiovascular Manifestations 2.2.3.3 Respiratory Manifestations 2.2.3.4 Hepatological Disorders 2.3 Toxicokinetics of OP 2.4 Assessment of Organophosphate Exposure 2.4.1 Through Metabolites of OP Present in the Urine 2.4.2 Blood Cholinesterase Activities 2.4.3 Other Methods of Detection 2.5 Future Prospect and Concern References Chapter 3: Enzymatic Targets of Organophosphates 3.1 Cholinergic Enzymes as Primary Targets of Organophosphate 3.2 Insights of Functional Aspect of Acetylcholinesterase 3.3 The Binding Pocket Is Lined with Conserved Aromatic Amino Acids 3.4 Mechanistic of Acetylcholinesterase Inhibition 3.4.1 Kinetic Behavior of Acetylcholinesterase Inhibition 3.4.2 Acetylcholinesterase: Reactivation Versus Aging 3.4.2.1 Aging of Acetylcholinesterase 3.4.3 Reactivation of Human Acetylcholinesterase 3.4.4 Feasibility of Reactivation of Aged Cholinesterase 3.5 Other Targets of Organophosphate 3.5.1 Butyrylcholinesterase (BuChE) 3.5.2 Arylformidase or Kynurenine Formidase 3.5.3 Neuropathy Target Esterase (NTE) 3.5.4 Acylpeptide Hydrolase (APH) 3.5.5 Monoacylglycerol Lipase (MAGL) and Fatty Acid Amide Hydrolase (FAAH) 3.6 Future Prospect and Major Concern References Chapter 4: Management and Modulation of Cholinesterase 4.1 Introduction 4.2 Resurrection of Acetylcholinesterase 4.2.1 Use of Oximes as Potential Reactivators of AChE 4.2.2 Bioscavenging the Organophosphates 4.2.2.1 Stoichiometric Bioscavengers 4.2.3 Catalytic Bioscavengers 4.2.4 Nanotechnology Approach 4.2.5 Realkylation of Aged AChE 4.3 Major Concern and Future Prospect References Chapter 5: Pharmacological Interventions for OP Poisoning 5.1 Introduction 5.2 The Antidotes for the Management of OP Poisoning 5.2.1 Atropinization: Controlling the Muscarinic Symptoms 5.2.1.1 Oximes: Rescuing the Phosphorylated Cholinesterases 5.2.2 Benzodiazepines: Seizure Management 5.3 Other Pharmacological Interventions 5.3.1 Magnesium Sulfate 5.3.2 Clonidine 5.3.3 Sodium Bicarbonate (NaHCO3) 5.3.4 Bioscavenging 5.4 Future Prospect and Major Concern References Chapter 6: Management of Human Organophosphate Poisoning 6.1 Introduction 6.2 Clinical Management 6.2.1 Initial Assessment of Poisoning 6.2.2 Identification of Causative Agent 6.2.3 Atropinization and Administration of Fluids 6.2.4 Use of Oximes 6.2.5 Procedures for Life Support 6.2.5.1 Resuscitation of Patients and Managing the Airway 6.2.5.2 Decontamination 6.2.5.3 Hemodialysis 6.3 Role of Community Health Management System 6.4 Policy Framework 6.4.1 Community Intervention and Training 6.4.2 Future Prospect and Major Concern