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Soman Poisoning

Poisoning by Soman


Presentation

  • A main focus of present-day pretreatment research is on bioscavengers, another is on centrally active reversible AChE-inhibitors combined with drugs showing anti-cholinergic, anti-glutamatergic, neuroprotective and non-sedating GABA-ergic activity.[ncbi.nlm.nih.gov]
  • In the present study, long-term effects of soman poisoning on learning ability, memory and neurogenesis were investigated in rats, treated with the anticholinergic atropine and the oxime HI-6 for reactivation of soman-inhibited acetylcholinesterase.[semanticscholar.org]
  • In this chapter, a review of the various neuroprotection options that have been investigated as alternatives to diazepam in the last decade is presented.[eurekaselect.com]
  • If the characteristic features of nerve agent poisoning are present, however, antidotal treatment should not be delayed until the result is available.[cryptome.org]
  • Twelve hours after she presented, a breathing tube was inserted and she was placed on a ventilator.[poison.org]
Bronchorrhea
  • Nerve agents cause death via respiratory failure, which in turn is caused by increased airway resistance (bronchorrhea, bronchoconstriction), respiratory muscle paralysis, and most importantly, loss of central respiratory drive. [10] Two chemical properties[emedicine.medscape.com]
  • Atropine : If bronchorrhea develops, atropine (2 mg in an adult; 20 microgram/kg in a child) should be administered intravenously every 5–10 minutes until secretions are minimal and the patient is atropinized (dry skin and sinus tachycardia).[cryptome.org]
Dyspnea
  • Exposure to low concentrations of nerve agent vapor produces immediate ocular symptoms, rhinorrhea, and in some patients, dyspnea.[emedicine.medscape.com]
  • Grading: Severity of exposure (used to dose antidote) Vapor Exposure (Effect in seconds, Peaks in minutes) Low Exposure Miosis Rhinorrhea Dyspnea High Exposure Altered Level of Consciousness Seizure s Apnea Flaccid Paralysis Death Liquid Exposure Small[fpnotebook.com]
Abdominal Cramps
  • cramps; epigastric and substernal tightness with “heartburn” and eructation; diarrhoea; tenesmus; involuntary defecation Increased/excessive sweating Increased/excessive salivation Increased/excessive lacrimation Bradycardia Slight miosis, occasionally[emro.who.int]
  • Reported side effects of PB include increased salivation, increased tearing, urinary urgency and frequency, nausea, vomiting, muscle weakness, abdominal cramps and diarrhea.167 These effects disappear when individuals stop taking PB.[pbs.org]
Suggestibility
  • These findings might suggest that HS6 and HI6 may have only limited value in the treatment of soman poisoning in man.[ncbi.nlm.nih.gov]
  • Dosing regimens vary, however, a suggested regimen is to give a loading dose of between 1 and 5 mg i.v. every 30 minutes until full atropinization, and maintenance doses of between 0.5 and 2 mg/hour.[emro.who.int]
  • During the trial, Murphy suggested that Spears ultimately killed her son because she was afraid that he would start telling people she was making him sick, calling her actions "nothing short of torture."[cosmopolitan.com]
  • These results demonstrate that TF-MSNs loaded with HI-6 represent the most effective antidote against NA poisoning by soman reported to date, and suggest that MSNs are a safe alternative to conventional drugs and an optimal nanocarrier for treating brain[pubs.rsc.org]
  • Some scientists suggest that persons who are genetically unable to produce the plasma enzyme butyryl cholinesterase (BuChE) could be more sensitive to PB's known side effects, and at least one apparent case has been reported.139 The estimated frequency[pbs.org]
Seizure
  • The current diazepam anticonvulsant could stop seizures when administrated early but its efficacy diminishes rapidly when applied late post seizures.[eurekaselect.com]
  • It causes seizures and has been used as a chemical warfare agent.[fpnotebook.com]
  • A large droplet of GB liquid rapidly causes loss of consciousness, seizures, paralysis, and apnea but only after a brief asymptomatic period typically lasting 10-30 minutes.[emedicine.medscape.com]
  • In addition to diazepam, lorazepam, midazolam and pentobarbital have been used to treat soman-induced seizures. Seizure control declines markedly if there is any delay in treatment; 40 minutes after exposure, control is minimal.[emro.who.int]
  • In January of 2014, Garnett was taken to the hospital with seizures. Two days after Garnett was admitted, he fell into a coma and died of acute sodium poisoning.[cosmopolitan.com]
Slurred Speech
  • speech Depression Respiratory depression Immediate treatment of person who has been exposed to a nerve agent exposure includes a complete washing of the eyes and skin with water.[faculty.washington.edu]
  • When an individual is exposed to low amounts of a nerve agent (as a gas or aerosol) the initial symptoms are a runny nose, contraction of the pupils, deterioration of visual accommodation, headache, slurred speech, nausea, hallucinations, pronounced chest[osha.gov]
Cognitive Deficit

Treatment

  • Essential antidotes in experimental treatment of Soman poisoning today are the powerful reactivators of Soman-inhibited AChE (e.g. HI-6, HGG-42 and BDB-27) and atropine.[ncbi.nlm.nih.gov]
  • These findings might suggest that HS6 and HI6 may have only limited value in the treatment of soman poisoning in man.[ncbi.nlm.nih.gov]
  • We also investigated whether sub-chronic treatment with the reported… CONTINUE READING[semanticscholar.org]
  • Inclusion of clonidine was vital for preventing atropine induced lethal ventricular arrhythmias in hypoxic animals when treatment was given late.[eurekaselect.com]
  • There are no guidelines regarding the treatment of OP poisoning during pregnancy.[medicinesinpregnancy.org]

Pathophysiology

  • Pathophysiology Penetrates skin, eyes, and lungs Toxic effects manifest as Cholinergic Toxicity Organophosphate esters ( Acetylcholinesterase Inhibitor s) Most toxic of chemical agents Similar to Insect icide Organophosphate s (e.g.[fpnotebook.com]

Prevention

  • The rapid onset of toxic signs following nerve agent intoxication and the apprehension that current therapy (atropine, oxime, diazepam) may not prevent brain damage, requires supportive pretreatment.[ncbi.nlm.nih.gov]
  • Inclusion of clonidine was vital for preventing atropine induced lethal ventricular arrhythmias in hypoxic animals when treatment was given late.[eurekaselect.com]
  • Centers for Disease Control and Prevention. 2003. Public Health Emergency Preparedness and Response Sheets. U.S. Department of Health and Human Services. Public Health Service; Atlanta, GA. U.S.[health.ny.gov]
  • All the nerve agents cause their toxic effects by preventing the proper operation of an enzyme that acts as the body’s “off switch” for glands and muscles. Without an “off switch,” the glands and muscles are constantly being stimulated.[emergency.cdc.gov]
  • All the nerve agents cause their toxic effects by preventing the proper operation of the chemical that acts as the body’s “off switch” for glands and muscles. Without an “off switch,” the glands and muscles are constantly being stimulated.[nationalterroralert.com]

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