Can be managed with benzodiazepines (varying doses in the textbooks, easy method is 0.1mg/kg IV for lorazepam (max 4mg) / midazolam (max 10mg) / diazepam (max 10mg). Check the patient is not in a dysrhythmia. Seizures – IV benzodiazepines incrementally dosed every 5 minutes to effect. Elimination of some organochlorines may take weeks to months. Undergo hepatic metabolism prior to urinary excretion. Highly lipid soluble and distribute to fat stores hence repeated occupational exposures is an important source. 
Most are well absorbed across the skin and via inhalation. Organophosphates and carbamates often have a hydrocarbon solvent that causes a headache and dizziness, this in and of itself does not indicate organophosphate poisoning. Pearl: Donepezil and tacrine are central-acting AChEIs that cause procholinergic side effects in overdose. Time for ageing occurs is variable between agents. Once “ageing” has occurred AChE can not be reactivated by the antidote pralidoxime. Ageing is the irreversible loss of an alkyl side chain which results in irreversible permanent binding to AChE. Organophosphates tend to be more toxic due to the “ageing” process. Organophosphosphorus agents inhibit acetylcholinesterase (AChE) enzymes and increase acetylcholine (Each) concentration at both muscarinic and nicotinic cholinergic receptors. Chemical nerve agents: Sarin, Soman, Tabun and VX. Carbamates: Aidicarb, Carbendazim, Carbendazole, Carbazine, Carbaryl, Carbofuran, Ethienocarb, Fenobucarb, Oxamyl, Methomyl and Propoxur. Organophosphates: Chlorpyrifos, Coumaphos, Diazinon, Dichlorvos, Dimethoate, Ethion, Fenthion, Malathion, Parathion and Trichlorfon. Organophosphorus agents can be broken down into three groups: 
Organophosphate and carbamate insecticides are responsible for 100,000+ deaths worldwide, particularly in developing countries due to its availability.
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