Akademik Veri Yönetim Sistemi
3. Uluslararası 28. Ulusal Farmakoloji , Antalya, Türkiye, 20 Kasım - 23 Aralık 2025, ss.65-66, (Özet Bildiri)
Serum amylase level as a prognostic factor in carbamate insecticide poisoning: A case report Bahar Eryılmaz1 , Aylin Arıcı1 , Volkan Hancı2 , Süleyman Dolu3 , Sedat Yanturalı4 , Yeşim Tunçok1 1Department of Medical Pharmacology, Dokuz Eylül University Faculty of Medicine, Izmir 2Department of Anesthesiology and Reanimation, Dokuz Eylül University Faculty of Medicine, Izmir 3Department of Internal Medicine, Gastroenterology, Dokuz Eylül University Faculty of Medicine, Izmir 4Department of Emergency Medicine, Dokuz Eylül University Faculty of Medicine, Izmir Objective: Carbamate insecticides, like methomyl, reversibly inhibit acetylcholinesterase, with poisoning symptoms typically subsiding within 24 hours.This case presentation evaluates serum amylase levels as a prognostic indicator in carbamate insecticide poisoning. Case: A 40-year-old man was brought to the emergency room one hour after ingesting an insecticide containing 90% methomyl for suicidal purposes.The patient had a history of hypertension and seizures post-ingestion.Physical examination revealed poor condition, unconsciousness, a Glasgow Coma Score of 3, hypersalivation, sweating, and miosis.Blood pressure was 200/100mmHg, pulse was 82/min, respiratory rate was 16/min, temperature was 36°C, and SpO₂ was 80%.He was taken to the resuscitation room, his clothing was removed, he was intubated, and treated with diazepam and sodium bicarbonate for seizures and acidosis.A 1mg atropine intravenous bolus was administered at 10-minute intervals, followed by a 3mg atropine infusion at 1ml/h.At admission, pseudocholinesterase level was measured as 2271U/L and serum amylase as 212U/L.He was admitted to ICU.Chest X-ray revealed pulmonary edema. On the second day, intravenous lipid emulsion was started and stopped at the 12th hour, with pseudocholinesterase level as 10.122U/L and amylase level as 602U/L.He remained intubated and was monitored with pseudocholinesterase levels remained high on the third and fourth days(8.912U/L,7.910U/L).The patient was extubated by day four and transferred to the psychiatric ward by day eight.Follow-up amylase levels fluctuated between 447U/L and 258U/L. Serum lipase levels ranged from 2060U/L to 1079U/L with no signs of acute pancreatitis.He was discharged on day 18. Conclusion: In this case, serum amylase levels fluctuated and remained elevated. Hyperamylasemia is considered a poor prognostic factor in organophosphate insecticide poisoning. Pancreatic damage caused by increased exocrine pancreatic secretion secondary to increased pancreatic duct pressure and cholinergic stimulation can be presented with painless hyperamylasemia. Clarification of the relationship between amylase levels and prognosis of the carbamate insecticide poisoning needs further research. Keywords: amylase, carbamate insecticide, methomyl, poisoning, prognostic factor