- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00389259
Scopolamine Treatment for Patients With Organophosphate Poisoning
Scopolamine Treatment for Patients With Organophosphate Poisoning - a Randomized, Double Blind, Placebo-Controlled Study.
Organophosphate (OP) compounds are a major threat as chemical warfare agents or in terrorist act. OPs are also the active ingredient of many insecticides. Ingestion of insecticides is a common cause of death among people who commit suicide in developing countries. OPs poisoning also frequently occurs after accidental exposure to agricultural OPs and in children as a result of unintentional ingestion.
The use of competitive inhibitors of acetylcholine other than atropine for patient with organophosphate (OP) poisoning is controversial. Because scopolamines' ability to cross the blood brain barrier is better than atropine, it has been suggested that scopolamine should be used OP poisoned patients who have central nervous system (CNS) manifestations. However there is controversy regarding its potential benefit in the treatment of organophosphate poisoning in humans. To the best of our knowledge there are no randomised controlled studies on the use of scopolamine in humans. This prospective randomised controlled study is aimed to determine whether adding scopolamine to the standard treatment of atropine and oximes in patients with CNS symptoms of OP poisoning improve the outcome.
Study Overview
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
-
Haifa, Israel
- Rambam Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age: 2- 60 years
At least two of the following three criteria:
- Known exposure to an organophosphate or carbamate insecticide in the last 72 hours.
- Symptoms and signs typical to organophosphate poisoning involving at least two systems (gastrointestinal, respiratory, skin, eyes,) See appendix
- Low levels of plasma butyrylcholinesterase (less than 50% of the lower normal range )
- CNS involvement in the first 72 hours after exposure: determined by finding at least one of the following major criteria or at least two of the minor criteria
Major criteria for CNS involvement:
- Seizures
- Extrapyramidal or Parkinson like symptoms
- Decreased level of consciousness (GCS< 12)
Minor criteria for CNS involvement:
- GCS 14-12
- Confusion
- Hallucinations
Exclusion Criteria:
- Hypersensitivity to scopolamine
- Glaucoma, narrow-angle (angle-closure)
- Tachyarrhythmias, congestive heart failure
- Obstructive gastrointestinal disease
- Myasthenia Gravis
- Reflux esophagitis
- Ulcerative colitis
- Known obstructive uropathy
- Pregnancy
- Patient or legal guardian unable to give informed consent (see comment under ethics)
- Severe co-morbidity (multi-trauma, advanced cancer, etc)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: A
IV Scopolamine 0.25mg in adults and 0.006mg/kg in children Q4h
|
IV placebo q4h
|
Placebo Comparator: B
IV Look alike drug Q 4h
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IV placebo q4h
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Improvement in neurological status as measured by the Glasgow Coma Scale
Time Frame: 1 week
|
1 week
|
Duration of seizures.
Time Frame: 1 week
|
1 week
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Number of days on ventilator
Time Frame: 1 week
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1 week
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Total cumulative dose of atropine
Time Frame: 1 week
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1 week
|
Need for benzodiazepines
Time Frame: 1 week
|
1 week
|
Number of days in the ICU
Time Frame: 2 weeks
|
2 weeks
|
Adverse effects and complications
Time Frame: 2 weeks
|
2 weeks
|
Neurological assessment at discharge
Time Frame: 2 weeks
|
2 weeks
|
Neurological assessment 3 month after the exposure
Time Frame: 3 month
|
3 month
|
Neuro-cognitive assessment at 3 month
Time Frame: 3 month
|
3 month
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Survival at 24 hours
Time Frame: 24 hours
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24 hours
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Survival to discharge
Time Frame: 4 weeks
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4 weeks
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Number of days in hospital
Time Frame: 4 weeks
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4 weeks
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Eran Kozer, MD, Assaf-Harofeh Medical Center
Study record dates
Study Major Dates
Study Start
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 70/04*1
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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