Presentation
A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories. [books.google.de]
If the characteristic features of nerve agent poisoning are present, however, antidotal treatment should not be delayed until the result is available. [cryptome.org]
The aim of the present study was to evaluate the efficacy of some ChE reactivators against OPC intoxication (tabun, paraoxon and dichlorvos) in in vitro experiments and to compare their activity to that known for some currently used oximes (obidoxime, [agris.fao.org]
The structures of GA, 2-PAM, DZP and DZPanion are presented in Figure 2. [scielo.br]
[…] identification incident Kluwer Academic Publishers laboratory luminescence luminometry mass destruction materials method military monitoring nerve agents Neurokinin Orahovec organization parameters pathogens peptides personnel potential preparedness present [books.google.com]
Entire Body System
- Weakness
Additional stereoelectronic features relating activity with the location of molecular orbitals and weak electrostatic potential field over the aromatic rings were found to be consistent with the pharmacophore model. [pubs.acs.org]
Nicotinic effects Skeletal muscle initially exhibits fasciculation (involuntary irregular, violent muscle contractions) followed by the inability to repolarize cell membranes resulting in weakness and paralysis. [openanesthesia.org]
At nicotinic receptors in skin, nerve agents cause sweating, and on skeletal muscle, they cause initial defasciculation followed by weakness and flaccid paralysis. [emedicine.medscape.com]
Tabun reacts readily with bases and weak acids. When heated to decomposition, tabun can emit highly toxic fumes. Tabun decomposes slowly in water. Raising the pH increases the rate of decomposition significantly. [cdc.gov]
muscular twitching; fasciculations; cramps; generalized weakness, including muscles of respiration, with dyspnoea and cyanosis Principles of medical management Remove the victim from contaminated area Give antidotes (atropine and oximes) to symptomatic [emro.who.int]
- Fatigue
At CNS cholinergic receptors, nerve agents produce irritability, giddiness, fatigue, lethargy, amnesia, ataxia, seizures, coma, and respiratory depression. [6, 7] Nerve agents also cause tachycardia and hypertension via stimulation of the adrenal medulla [emedicine.medscape.com]
[…] eructation; diarrhoea; tenesmus; involuntary defecation Increased/excessive sweating Increased/excessive salivation Increased/excessive lacrimation Bradycardia Slight miosis, occasionally unequal Blurring of vision Frequency; involuntary urination Easy fatigue [emro.who.int]
Respiratoric
- Bronchorrhea
Intubation may be necessary in cases of respiratory distress due to laryngospasm, bronchospasm, bronchorrhea, or seizures. Immediate aggressive use of atropine may eliminate the need for intubation. [openanesthesia.org]
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]
Gastrointestinal
- Abdominal Cramps
[…] absorption Tightness in chest, with prolonged wheezing expiration suggestive of bronchoconstriction or increased secretion; dyspnoea, slight pain in chest; increased bronchial secretion; cough; pulmonary oedema; cyanosis Anorexia; nausea; vomiting; abdominal [emro.who.int]
Atropine also blocks other effects of poisoning, such as nausea, vomiting, abdominal cramping, low heart rate, and sweating. Atropine, however, does not prevent or reverse paralysis. [emedicinehealth.com]
Cardiovascular
- Tachycardia
Tachycardia and mydriasis must not be used to limit or to stop subsequent doses of atropine. The main concern with OP toxicity is respiratory failure from excessive airway secretions. [openanesthesia.org]
At CNS cholinergic receptors, nerve agents produce irritability, giddiness, fatigue, lethargy, amnesia, ataxia, seizures, coma, and respiratory depression. [6, 7] Nerve agents also cause tachycardia and hypertension via stimulation of the adrenal medulla [emedicine.medscape.com]
Bradycardia, tachycardia and hypotension may occur dependent on whether muscarinic or nicotinic effects predominate. If exposure is substantial, death may occur from respiratory failure within minutes. [cryptome.org]
Changes in heart rate are less important but easier to follow, and a mild tachycardia of 80 beats or more per minute should be maintained. Besides atropine, a centrally acting anticonvulsant should be administered, diazepam being the drug of choice. [emro.who.int]
- Hypertension
Phentolamine for 2-PAM chloride-induced hypertension: 1 mg IV for children; 5 mg IV for adults. [health.ny.gov]
At CNS cholinergic receptors, nerve agents produce irritability, giddiness, fatigue, lethargy, amnesia, ataxia, seizures, coma, and respiratory depression. [6, 7] Nerve agents also cause tachycardia and hypertension via stimulation of the adrenal medulla [emedicine.medscape.com]
Miosis (contraction of the pupil), blurred vision, lacrimation, tachycardia (rapid heart beat) or bradycardia (slow heart beat), hypertension or hypotension, and chest pain also are common. [cameochemicals.noaa.gov]
Jaw & Teeth
- Hypersalivation
Atropine sulfate blocks the muscarinic effects of acetylcholine that cause bronchorrhoea, hypersalivation, bronchoconstriction and bradycardia, thereby reducing these effects. [emro.who.int]
- Foaming at the Mouth
Excessive acetylcholine corroborates what has been reported and seen in the videos taken just after the attack, including uncontrolled salivation that will cause "foaming at the mouth," vomiting, tearing, involuntary defecation and urination, tiny pinpoint [tonic.vice.com]
Neurologic
- Seizure
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]
Severe effects of nerve agents include unconsciousness, seizures, apnea, flaccid paralysis. [health.ny.gov]
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]
Anticonvulsants for soman-induced seizure activity. J Biomed Sci 1999;6:86-96. Thiermann H, Szinicz L, Eyer P, Felgenhauer N, Zilker T, Worek F. [degruyter.com]
- Giddiness
At CNS cholinergic receptors, nerve agents produce irritability, giddiness, fatigue, lethargy, amnesia, ataxia, seizures, coma, and respiratory depression. [6, 7] Nerve agents also cause tachycardia and hypertension via stimulation of the adrenal medulla [emedicine.medscape.com]
Workup
Workup Approach Considerations Although no laboratory test exists to directly measure nerve agent levels in serum or urine, the acute effects of nerve agents can be estimated by measuring the percent reduction in the activity of red blood cell (RBC) cholinesterase [emedicine.medscape.com]
Rhythm
- Torsades De Pointes
Torsades de Pointes should be treated in the standard manner. The use of intravenous magnesium sulfate has been reported as beneficial for organophosphate toxicity. [openanesthesia.org]
Nerve agent toxicity has been associated with PR interval prolongation, QT prolongation, and torsade de pointes. [emedicine.medscape.com]
Treatment
Oxime doses of 25% or 5% of its LD(50) were used for pretreatment 15 min before tabun-poisoning and for treatment 1 min after tabun administration to mice. [ncbi.nlm.nih.gov]
AB - Acetylcholinesterase reactivators are crucial antidotes for the treatment of organophosphate intoxication. [risweb.st-andrews.ac.uk]
Antidotal treatment involving centrally acting anticholinergic drugs (benactyzine, biperiden, scopolamine) showed significantly higher neuroprotective efficacy compared to antidotal treatment containing atropine. Keywords [doaj.org]
Posted on 01.11.2007 - 00:00 Acetylcholinesterase reactivators are crucial antidotes for the treatment of organophosphate intoxication. [figshare.com]
Prognosis
Mustards Prognosis Victims with significant respiratory tract burns usually require admission to the hospital’s intensive care unit. [emedicinehealth.com]
Epidemiology
Biden: Syrian gov't responsible for "heinous use" of chem. weapons Syrian state news agency: Kerry lying about chemical weapons attack "The reported symptoms of the patients, in addition to the epidemiological pattern of the events -- characterized by [cbsnews.com]
A chart of signs and symptoms is available from the North Carolina Statewide Program for Infection Control and Epidemiology. [emedicinehealth.com]
Journal of Epidemiology. 9 (5): 337–43. doi : 10.2188/jea.9.337. PMID 10616267. ^ Millard CB, Kryger G, Ordentlich A, Greenblatt HM, Harel M, Raves ML, Segall Y, Barak D, Shafferman A, Silman I, Sussman JL (June 1999). [en.wikipedia.org]
Prevention
Abstract A pretreatment for organophosphorus (OP) anticholinesterase (e.g., soman) intoxication should prevent lethality and convulsions (CNV) at 2 LD50s and be behavioral-decrement-free when given alone. [ncbi.nlm.nih.gov]
Darkness prevented them from identifying it as unknown and dangerous. The men were severely injured and had to be evacuated to Copenhagen. In 1997, the Polish vessel F.V. [oceanhealthindex.org]
Contaminated clothing should be double-bagged after removal to prevent further exposure. It is important that anyone treating a contaminated person should wear appropriate personal protective equipment to avoid exposure. [health.ny.gov]
Decontamination after the first few minutes of exposure does not prevent further damage later but at least prevents spread of the chemical to other parts of the body and protects emergency care personnel from further contact exposure. [emedicinehealth.com]
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]