Medical management of incidents with chemical warfare agents

Unequal Efficacy of Pyridinium Oximes in Acute Organophosphate Poisoning

“…24,25 Therefore, its measurement is of high value for therapeutic management, especially oxime administration, during the course of intoxication. 17 Inhibition of BuChE, whose physiological role is still unclear, can be ascertained by clinical laboratory procedures and will confirm the clinical diagnosis. Even more, BuChE has been recognized as a bioscavenger of OPCs, thereby decreasing the organophosphate concentration in the organism.…”

“…In children, a loading dose of 25 to 50 mg/kg PAM-2 can be used, followed by continuous infusion of 10 to 20 mg/kg/h. 17 Other PAM-2 salts are also on the market (i.e., iodide, methylsulfate and mesylate) and can be used in corresponding doses.…”

“…Namely, the repeated use of nerve agents during the Iran-Iraq war in the 1980s, 10 against civilians by Iraqi troops, 11 and during terrorist attacks by the Aum Shinrikyo sect in Japan 12-15 emphasize the constant threat and need for increased awareness of the potential for future homicidal attempts, as well as the urgent need for the development of an effective medical treatment regimen. 16,17 The mechanism of action of OPCs, as well as factors contributing to toxic response, will be briefly discussed in this paper. Treatment of acute poisoning caused by this class of substances will be considered through a correlation of experimental data and clinical findings, with special attention to oxime efficacy against chemically different cholinesterase inhibitors.…”

Medical Treatment of Poisoning with Organophosphates and Carbamates

“…Other authors have stated that atropine can only partly block convulsions after exposure to these agents because other transmitter systems (GABA, glutamate) become involved in cholinergic overstimulation in the brain (Antonijević and Stojiljković, 2007;Zilker, 2005).…”

Percutaneous Toxicity and Decontamination of Soman, Vx, and Paraoxon in Rats Using Detergents

“…Many different decontamination methods have been developed (4)(5)(6). The most common one for mass casualties is wet type decontamination using detergents (7,8).…”