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Acetylcholinesterase (AChE)

Definition

The enzyme that hydrolyses acetylcholine at cholinergic synapses. Inhibition by organophosphates or carbamates causes accumulation of acetylcholine at muscarinic, nicotinic and central receptors and produces the cholinergic toxidrome.

Function
Hydrolyses acetylcholine at cholinergic synapses
Inhibited by
Organophosphates, carbamates
Inhibition effect
Accumulated acetylcholine at receptors
Resulting syndrome
Cholinergic toxidrome

Common questions

What distinguishes the cholinergic toxidrome clinically?+

A combination of muscarinic signs such as salivation and bronchorrhea, nicotinic signs such as fasciculations and weakness, and central effects such as confusion and seizures appearing together.

Why does carbamate poisoning management differ from organophosphate poisoning?+

Carbamates bind AChE reversibly and typically resolve faster on their own, while organophosphates can bind essentially permanently unless treated promptly, making early antidote timing more critical for OPs.

How is AChE inhibition confirmed in a suspected poisoning case?+

Blood cholinesterase activity assays, using red cells or plasma, measure how far enzyme activity has dropped from a normal baseline, supporting the poisoning diagnosis.

Related terms

Aging
The irreversible loss of one alkyl group from the phosphorylated AChE-organophosphate complex, after which oximes can no longer reactivate the enzyme. Aging...
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DUMBBELS
Mnemonic for the muscarinic side of the cholinergic toxidrome: Diarrhoea, Urination, Miosis, Bronchospasm and Bronchorrhoea, Bradycardia, Emesis, Lacrimation, Salivation.
Intermediate Syndrome
Proximal muscle and respiratory weakness appearing 24 to 96 hours after acute organophosphate exposure, requiring mechanical ventilation, distinct from the acute cholinergic...
OPIDN
Organophosphate-induced delayed polyneuropathy: a distal sensorimotor neuropathy appearing 2 to 3 weeks after exposure to certain OPs (TOCP, leptophos), mediated by neuropathy...
Phosphine (PH3)
The toxic gas liberated when aluminium phosphide reacts with water or gastric acid. It inhibits mitochondrial cytochrome c oxidase, generates reactive oxygen...

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